Asensus Surgical (TRXDW) 10-Q 5 Aug 21 2021 Q2 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2021	Jul. 30, 2021
Document Information [Line Items]
Entity Central Index Key	0000876378
Entity Registrant Name	ASENSUS SURGICAL, INC.
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	Q2
Document Fiscal Year Focus	2021
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2021
Document Transition Report	false
Entity File Number	0-19437
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	11-2962080
Entity Address, Address Line One	1 TW Alexander Drive, Suite 160
Entity Address, City or Town	Durham
Entity Address, State or Province	NC
Entity Address, Postal Zip Code	27703
City Area Code	919
Local Phone Number	765-8400
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common Stock $0.001 par value per share
Trading Symbol	ASXC
Security Exchange Name	NYSEAMER
Entity Common Stock, Shares Outstanding		234,323,983

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Revenue:
Revenue	$ 1,102	$ 655	$ 3,185	$ 1,255
Cost of revenue:
Cost of revenue	2,347	1,413	5,459	3,151
Gross loss	(1,245)	(758)	(2,274)	(1,896)
Operating Expenses:
Research and development	4,089	4,257	8,304	8,191
Sales and marketing	3,562	2,901	6,615	7,154
General and administrative	3,848	3,619	7,840	6,968
Amortization of intangible assets	2,862	2,619	5,729	5,183
Change in fair value of contingent consideration	478	212	735	1,268
Restructuring and other charges	0	0	0	858
Total Operating Expenses	14,839	13,608	29,223	29,622
Operating Loss	(16,084)	(14,366)	(31,497)	(31,518)
Other Income (Expense)
Gain on extinguishment of debt	2,847	0	2,847	0
Change in fair value of warrant liabilities	0	(114)	(1,981)	(269)
Interest income	79	4	131	31
Interest expense	(5)	0	(12)	0
Other expense, net	(7)	(55)	(36)	(70)
Total Other Income (Expense), net	2,914	(165)	949	(308)
Loss before income taxes	(13,170)	(14,531)	(30,548)	(31,826)
Income tax (expense) benefit	(2)	691	36	1,388
Net loss	(13,172)	(13,840)	(30,512)	(30,438)
Deemed dividend related to beneficial conversion feature of preferred stock	0	0	0	(412)
Deemed dividend related to conversion of preferred stock into common stock		(299)	0	(299)
Net loss attributable to common stockholders	(13,172)	(14,139)	(30,512)	(31,149)
Comprehensive loss:
Net loss	(13,172)	(13,840)	(30,512)	(30,438)
Foreign currency translation gain (loss)	472	962	(1,466)	90
Comprehensive loss	$ (12,700)	$ (12,878)	$ (31,978)	$ (30,348)
Net loss per common share attributable to common stockholders - basic and diluted (in dollars per share)	$ (0.06)	$ (0.27)	$ (0.14)	$ (0.77)
Weighted average number of shares used in computing net loss per common share - basic and diluted (in shares)	233,250	52,351	219,199	40,628
Product [Member]
Revenue:
Revenue	$ 696	$ 315	$ 2,400	$ 557
Cost of revenue:
Cost of revenue	1,478	720	3,858	1,633
Service [Member]
Revenue:
Revenue	406	340	785	698
Cost of revenue:
Cost of revenue	$ 869	$ 693	$ 1,601	$ 1,518

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Current Assets:
Cash and cash equivalents	$ 157,078	$ 16,363
Accounts receivable, net	960	1,115
Inventories	12,523	10,034
Other current assets	3,446	6,501
Total Current Assets	174,007	34,013
Restricted cash	1,045	1,166
Inventories, net of current portion	6,590	8,813
Property and equipment, net	9,876	10,342
Intellectual property, net	15,943	22,267
Net deferred tax assets	288	307
Operating lease right-of-use assets, net	4,099	1,164
Other long term assets	156	186
Total Assets	212,004	78,258
Current Liabilities:
Accounts payable	2,653	1,965
Accrued expenses	4,007	5,615
Operating lease liabilities - current portion	861	686
Deferred revenue	786	789
Notes payable - current portion, net of debt discount	0	1,228
Total Current Liabilities	8,307	10,283
Long Term Liabilities:
Contingent consideration	4,671	3,936
Noncurrent operating lease liabilities	3,465	628
Notes payable, less current portion	0	1,587
Warrant liabilities	0	255
Total Liabilities	16,443	16,689
Commitments and Contingencies (Note 10)
Stockholders' Equity:
Common stock $0.001 par value, 750,000,000 shares authorized at June 30, 2021 and December 31, 2020; 234,231,132 and 116,231,072 shares issued and outstanding at June 30, 2021 and December 31, 2020, respectively	234	116
Preferred stock, $0.01 par value, 25,000,000 shares authorized, no shares issued and outstanding at June 30, 2021 and December 31, 2020	0	0
Additional paid-in capital	947,249	781,397
Accumulated deficit	(753,424)	(722,912)
Accumulated other comprehensive income	1,502	2,968
Total Stockholders' Equity	195,561	61,569
Total Liabilities and Stockholders' Equity	212,004	78,258
Intellectual Property [Member]
Current Assets:
Intellectual property, net	$ 15,943	$ 22,267

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares	Jun. 30, 2021	Dec. 31, 2020
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	750,000,000	750,000,000
Common stock, shares issued (in shares)	234,231,132	116,231,072
Common stock, shares outstanding (in shares)	234,231,132	116,231,072
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	25,000,000	25,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Changes in Stockholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Public Offering [Member]Common Stock [Member]	Public Offering [Member]Preferred Stock [Member]	Public Offering [Member]Treasury Stock [Member]	Public Offering [Member]Additional Paid-in Capital [Member]	Public Offering [Member]Retained Earnings [Member]	Public Offering [Member]AOCI Attributable to Parent [Member]	Public Offering [Member]	Common Stock [Member]	Preferred Stock [Member]	Treasury Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Total
Balance (in shares) at Dec. 31, 2019								20,691	0	0
Balance at Dec. 31, 2019								$ 21	$ 0	$ 0	$ 720,484	$ (663,600)	$ (1,370)	$ 55,535
Stock-based compensation								$ 0	$ 0	$ 0	1,923	0	0	1,923
Issuance of common stock, net of issuance costs (in shares)	14,122	7,937	0					7,030	0	0
Issuance of common stock, net of issuance costs	$ 14	$ 79	$ 0	$ 13,432	$ 0	$ 0	$ 13,525	$ 7	$ 0	$ 0	11,205	0	0	11,212
Award of restricted stock units (in shares)								141	0	0
Award of restricted stock units								$ 0	$ 0	$ 0	0	0	0	0
Return of common stock to pay withholding taxes on restricted stock (in shares)								0	0	28
Return of common stock to pay withholding taxes on restricted stock								$ 0	$ 0	$ 0	(33)	0	0	(33)
Cancellation of treasury stock (in shares)								0	0	(28)
Cancellation of treasury stock								$ 0	$ 0	$ 0	0	0	0	0
Other comprehensive loss								0	0	0	0	0	(872)	(872)
Net loss								$ 0	$ 0	$ 0	0	(16,598)	0	(16,598)
Conversion of preferred stock to common stock (in shares)								3,053	(3,053)	0
Conversion of preferred stock to common stock								$ 3	$ (30)	$ 0	27	0	0	0
Exchange of shares for Series B Warrants (in shares)								2,041	0	0
Exchange of shares for Series B Warrants								$ 2	$ 0	$ 0	2,468	0	0	2,470
Balance (in shares) at Mar. 31, 2020								47,078	4,884	0
Balance at Mar. 31, 2020								$ 47	$ 49	$ 0	749,506	(680,198)	(2,242)	67,162
Balance (in shares) at Dec. 31, 2019								20,691	0	0
Balance at Dec. 31, 2019								$ 21	$ 0	$ 0	720,484	(663,600)	(1,370)	55,535
Net loss														(30,438)
Balance (in shares) at Jun. 30, 2020								56,903	0	0
Balance at Jun. 30, 2020								$ 57	$ 0	$ 0	754,818	(694,038)	(1,280)	59,557
Balance (in shares) at Dec. 31, 2019								20,691	0	0
Balance at Dec. 31, 2019								$ 21	$ 0	$ 0	720,484	(663,600)	(1,370)	55,535
Exercise of stock options and warrants (in shares)								4,900
Balance (in shares) at Dec. 31, 2020								116,231	0	0
Balance at Dec. 31, 2020								$ 116	$ 0	$ 0	781,397	(722,912)	2,968	61,569
Balance (in shares) at Mar. 31, 2020								47,078	4,884	0
Balance at Mar. 31, 2020								$ 47	$ 49	$ 0	749,506	(680,198)	(2,242)	67,162
Stock-based compensation								$ 0	$ 0	$ 0	1,933	0	0	1,933
Exercise of stock options and warrants (in shares)								4,913	0	0
Exercise of stock options and warrants								$ 5	$ 0	$ 0	3,335	0	0	3,340
Award of restricted stock units (in shares)								28	0	0
Award of restricted stock units								$ 0	$ 0	$ 0	0	0	0	0
Other comprehensive loss								0	0	0	0	0	962	962
Net loss								$ 0	$ 0	$ 0	0	(13,840)	0	(13,840)
Conversion of preferred stock to common stock (in shares)								4,884	(4,884)	0
Conversion of preferred stock to common stock								$ 5	$ (49)	$ 0	44	0	0	0
Balance (in shares) at Jun. 30, 2020								56,903	0	0
Balance at Jun. 30, 2020								$ 57	$ 0	$ 0	754,818	(694,038)	(1,280)	59,557
Balance (in shares) at Dec. 31, 2020								116,231	0	0
Balance at Dec. 31, 2020								$ 116	$ 0	$ 0	781,397	(722,912)	2,968	61,569
Stock-based compensation								$ 0	$ 0	$ 0	1,786	0	0	1,786
Issuance of common stock, net of issuance costs (in shares)								70,666	0	0
Issuance of common stock, net of issuance costs								$ 71	$ 0	$ 0	129,251	0	0	129,322
Exercise of stock options and warrants (in shares)								45,114	0	0
Exercise of stock options and warrants								$ 45	$ 0	$ 0	32,687	0	0	32,732
Award of restricted stock units (in shares)								706	0	0
Award of restricted stock units								$ 1	$ 0	$ 0	0	0	0	1
Return of common stock to pay withholding taxes on restricted stock (in shares)								0	0	67
Return of common stock to pay withholding taxes on restricted stock								$ 0	$ 0	$ 0	(214)	0	0	(214)
Cancellation of treasury stock (in shares)								0	0	(67)
Cancellation of treasury stock								$ 0	$ 0	$ 0	0	0	0	0
Other comprehensive loss								0	0	0	0	0	(1,938)	(1,938)
Net loss								$ 0	$ 0	$ 0	0	(17,340)	0	(17,340)
Balance (in shares) at Mar. 31, 2021								232,717	0	0
Balance at Mar. 31, 2021								$ 233	$ 0	$ 0	944,907	(740,252)	1,030	205,918
Balance (in shares) at Dec. 31, 2020								116,231	0	0
Balance at Dec. 31, 2020								$ 116	$ 0	$ 0	781,397	(722,912)	2,968	61,569
Net loss														(30,512)
Balance (in shares) at Jun. 30, 2021								234,231	0	0
Balance at Jun. 30, 2021								$ 234	$ 0	$ 0	947,249	(753,424)	1,502	195,561
Balance (in shares) at Mar. 31, 2021								232,717	0	0
Balance at Mar. 31, 2021								$ 233	$ 0	$ 0	944,907	(740,252)	1,030	205,918
Stock-based compensation								$ 0	$ 0	$ 0	1,842	0	0	1,842
Issuance of common stock, net of issuance costs (in shares)								332	0	0
Issuance of common stock, net of issuance costs								$ 0	$ 0	$ 0	992	0	0	992
Exercise of stock options and warrants (in shares)								508	0	0
Exercise of stock options and warrants								$ 0	$ 0	$ 0	337	0	0	337
Award of restricted stock units (in shares)								674	0	0
Award of restricted stock units								$ 1	$ 0	$ 0	0	0	0	1
Return of common stock to pay withholding taxes on restricted stock (in shares)								0	0	246
Return of common stock to pay withholding taxes on restricted stock								$ 0	$ 0	$ 0	(829)	0	0	(829)
Cancellation of treasury stock (in shares)								0	0	(246)
Cancellation of treasury stock								$ 0	$ 0	$ 0	0	0	0	0
Other comprehensive loss								0	0	0	0	0	472	472
Net loss								$ 0	$ 0	$ 0	0	(13,172)	0	(13,172)
Balance (in shares) at Jun. 30, 2021								234,231	0	0
Balance at Jun. 30, 2021								$ 234	$ 0	$ 0	$ 947,249	$ (753,424)	$ 1,502	$ 195,561

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended		12 Months Ended
	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Operating Activities:
Net loss	$ (13,172)	$ (17,340)	$ (13,840)	$ (16,598)	$ (30,512)	$ (30,438)
Adjustments to reconcile net loss to net cash and cash equivalents used in operating activities:
Depreciation					1,585	1,162
Amortization of intangible assets	2,862		2,619		5,729	5,183
Stock-based compensation					3,628	3,856
Gain on extinguishment of debt	(2,847)		0		(2,847)	0
Deferred tax benefit					(36)	(1,388)
Write down of inventory	200		0		288	0
Change in fair value of warrant liabilities	0		114		1,981	269
Change in fair value of contingent consideration	478		212		735	1,268
Changes in operating assets and liabilities:
Accounts receivable					127	(350)
Inventories					(1,687)	(2,332)
Operating lease right-of-use assets					(2,970)	546
Other current and long term assets					3,177	281
Accounts payable					679	(1,221)
Accrued expenses					(1,428)	(1,451)
Deferred revenue					14	22
Operating lease liabilities					3,052	(608)
Other long term liabilities					0	65
Net cash and cash equivalents used in operating activities					(18,485)	(25,136)
Investing Activities:
Purchase of property and equipment					(700)	(3)
Net cash and cash equivalents used in investing activities					(700)	(3)
Financing Activities:
Proceeds from issuance of common stock, preferred stock and warrants under 2020 financing, net of issuance costs					0	13,525
Proceeds from issuance of common stock, net of issuance costs					130,314	11,212
Proceeds from notes payable, net of issuance costs					0	2,815
Taxes paid related to net share settlement of vesting of restricted stock units					(1,041)	(33)
Payment of contingent consideration					0	(74)
Proceeds from exercise of stock options and warrants					30,835	3,340
Net cash and cash equivalents provided by financing activities					160,108	30,785
Effect of exchange rate changes on cash and cash equivalents					(329)	17
Net increase in cash, cash equivalents and restricted cash					140,594	5,663
Cash, cash equivalents and restricted cash, beginning of period		$ 17,529		$ 10,567	17,529	10,567	$ 10,567
Cash, cash equivalents and restricted cash, end of period	$ 158,123		$ 16,230		158,123	16,230	$ 17,529
Supplemental Schedule of Non-cash Investing and Financing Activities:
Transfer of inventories to property and equipment					1,243	3,403
Acquisition of property and equipment in accounts payable					67	0
Reclass of warrant liability to common stock and additional paid-in-capital					2,236	0
Lease liabilities arising from obtaining right-of-use assets					3,461	0
Exchange of common stock for Series B Warrants					0	2,470
Transfer of in-process research and development to intellectual property					0	2,425
Conversion of preferred stock to common stock					$ 0	$ 79

Note 1 - Organization and Capit

Note 1 - Organization and Capitalization	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Organization, Consolidation, Basis of Presentation, Business Description and Accounting Policies [Text Block]	1. Organization and Capitalization Asensus Surgical, Inc. (formerly known as TransEnterix, Inc.) (the "Company") is a medical device company that is digitizing the interface between the surgeon and the patient to pioneer a new era of Performance-Guided Surgery™ by unlocking clinical intelligence for surgeons to enable consistently superior outcomes and a new standard of surgery. The Company is focused on the market development for and commercialization of the Senhance® Surgical System, which digitizes laparoscopic minimally invasive surgery, or MIS. The Senhance System is the first 3 The Senhance System is available for sale in Europe, the United States, Japan, Taiwan, Russia and select other countries. • The Senhance System has a CE Mark in Europe for adult and pediatric laparoscopic abdominal and pelvic surgery, as well as limited thoracic surgeries excluding cardiac and vascular surgery. • In the United States, the Company has received 510 31 • In Japan, the Company has received regulatory approval and reimbursement for 98 • The Senhance System has received its registration certificate by the Russian medical device regulatory agency, Roszdravnadzor, allowing for its sale and utilization throughout the Russian Federation. In 2020, February 12, 2020, 3 March 13, 2020 first September 23, 2020, first On January 19, 2021, July 28, 2021, 5 two On October 31, 2018, one October 2019, At-the-Market Offering On May 19, 2021, SM May 19, 2021, “2021 3 No. 333 256284 May 19, 2021.

Note 2 - Summary of Significant

Note 2 - Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Significant Accounting Policies [Text Block]	2. Summary of Significant Accounting Policies Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and include the accounts of the Company and its direct and indirect wholly owned subsidiaries. The Company has prepared the accompanying unaudited interim condensed consolidated financial statements in accordance with the instructions to Form 10 not 10 10 not may 2020 10 not Liquidity The Company had an accumulated deficit of $753.4 million and working capital of $165.7 million as of June 30, 2021. not may The Company believes the COVID- 19 In the first 2021, January 2021 January 2021 2020 “2020 six June 30, 2021 In the second 2021, 2021 three June 30, 2021. As of June 30, 2021, While the Company believes that its existing cash and cash equivalents as of June 30, 2021 12 may may 2021 Risk and Uncertainties The Company is subject to risks similar to other similarly sized companies in the medical device industry. These risks include, without limitation: potential negative impacts on the Company's operations caused by the COVID- 19 Use of Estimates The preparation of 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 the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Significant items subject to such estimates and assumptions include impairment considerations for long- term intangible assets, fair value estimates related to contingent consideration, warrant liabilities, stock compensation expense, revenue recognition, accounts receivable reserves, excess and obsolete inventory reserves, inventory classification between current and non-current, measurement of lease liabilities and corresponding ROU assets, and deferred tax asset valuation allowances. The COVID- 19 19 19 19 19 Principles of Consolidation and Foreign Currency Considerations The accompanying Condensed Consolidated Financial Statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., SafeStitch LLC, Asensus International, Inc., Asensus Surgical Italia S.r.l., Asensus Surgical Europe S.à.r.l., Asensus Surgical Taiwan Ltd., Asensus Surgical Japan K.K., Asensus Surgical Israel Ltd., Asensus Surgical Netherlands B.V., and Asensus Surgical Canada, Inc. All inter-company accounts and transactions have been eliminated in consolidation. The functional currency of the Company’s operational foreign subsidiaries is predominantly the Euro. The assets and liabilities of the Company’s foreign subsidiaries are translated into U.S. dollars at exchange rates in effect at the balance sheet date. Income and expense items are translated at the average exchange rates prevailing during the period. The cumulative translation effect for a subsidiary using a functional currency other than the U.S. dollar is included in accumulated other comprehensive income or loss as a separate component of stockholders’ equity. The Company’s intercompany accounts are denominated in the functional currency of the foreign subsidiary. Gains and losses resulting from the remeasurement of intercompany receivables that the Company considers to be of a long-term investment nature are recorded as a cumulative translation adjustment in accumulated other comprehensive income or loss as a separate component of stockholders’ equity, while gains and losses resulting from the remeasurement of intercompany receivables from a foreign subsidiary for which the Company anticipates settlement in the foreseeable future are recorded in the condensed consolidated statements of operations and comprehensive loss. The net gains and losses included in net loss in the condensed consolidated statements of operations and comprehensive loss for the three six June 30, 2021 2020 not Cash and Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with original maturities of 90 Restricted cash as of June 30, 2021 December 31, 2020 Concentrations and Credit Risk The Company’s principal financial instruments subject to potential concentration of credit risk are cash and cash equivalents, including amounts held in money market accounts. The Company places cash deposits with a federally insured financial institution. The Company maintains its cash at banks and financial institutions it considers to be of high credit quality; however, the Company’s domestic cash deposits may may not not not The Company’s accounts receivable are derived from sales and leases to customers located throughout the world. The Company evaluates its customers’ financial condition and, generally, requires no no three six June 30, 2021 2020. June 30, 2021. seven December 31, 2020. three June 30, 2021 three June 30, 2020. six June 30, 2021 six June 30, 2020. Accounts Receivable Accounts receivable are recorded at net realizable value, which includes an allowance for estimated uncollectible accounts. The allowance for uncollectible accounts was determined on a customer specific basis based on deemed collectability. The allowance for doubtful accounts was $1.7 million and $1.8 million as of June 30, 2021 December 31, 2020, Inventories Inventories are stated at the lower of cost (determined on a first first not Any inventory on hand at the measurement date in excess of the Company's current requirements based on anticipated levels of sales is classified as long-term on the Company's condensed consolidated balance sheets. The Company's classification of long-term inventory requires it to estimate the portion of on hand inventory that can be realized over the upcoming twelve Intellectual Property Intellectual property consists of purchased patent rights and developed technology acquired as part of previous business acquisitions. Amortization of the patent rights is recorded using the straight-line method over the estimated useful life of the patents of 10 years. Amortization of the developed technology is recorded using the straight-line method over the estimated useful life of 5 to 7 years. The Company periodically evaluates intellectual property for impairment whenever events or changes in circumstances indicate that the carrying amount may not three six June 30, 2021 2020. Property and Equipment Property and equipment consists primarily of operating lease Senhance System assets, machinery, manufacturing equipment, demonstration equipment, computer equipment, furniture, and leasehold improvements, which are recorded at cost less accumulated depreciation. Depreciation is recorded using the straight-line method over the estimated useful lives of the assets as follows: Operating lease assets – Senhance System leasing (in years) 5 Machinery, manufacturing and demonstration equipment (in years) 3-5 Computer equipment (in years) 3 Furniture (in years) 5 Leasehold improvements Lesser of lease term or 3 to 10 years Upon retirement or sale, the cost of assets disposed of and the related accumulated depreciation and amortization are removed from the accounts and any resulting gain or loss is credited or charged to operations. Repairs and maintenance costs are expensed as incurred. The Company reviews its property and equipment assets for possible impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not not three six June 30, 2021 2020. Notes Payable Payroll Protection Program The Company’s policy is to account for forgivable loans received through the U.S. Small Business Administration (the “SBA”) under the CARES Act Payroll Protection Program (“PPP”), as debt in accordance with ASC 470, June 10, 2021, Contingent Consideration Contingent consideration is recorded as a liability and is the estimate of the fair value of potential milestone payments related to business acquisitions. Contingent consideration is measured at fair value using a discounted cash flow model utilizing significant unobservable inputs including the probability of achieving each of the potential milestones, future Euro-to-USD exchange rates, and an estimated discount rate associated with the risks of the expected cash flows attributable to the various milestones. Significant increases or decreases in any of the probabilities of success or changes in expected achievement of any of these milestones would result in a significantly higher or lower fair value of these milestones, respectively, and commensurate changes to the associated liability. The contingent consideration is revalued at each reporting period and changes in fair value are recognized in the condensed consolidated statements of operations and comprehensive loss. On September 21, 2015, 2016, June 30, 2021 € 25.0 Warrant Liabilities The Company’s Series B Warrants (see Note 8 3 first 2021. Revenue Recognition The Company’s revenue consists of product revenue resulting from the sale and lease of Systems, System components, instruments and accessories, and service revenue. The Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and the customer, the rights of the parties are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company's revenues are measured based on consideration specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government authorities. The Company’s System sale arrangements generally include a five first four The Company’s System sale arrangements generally contain multiple products and services. For these consolidated sale arrangements, the Company accounts for individual products and services as separate performance obligations if they are distinct, which is if a product or service is separately identifiable from other items in the consolidated package, and if a customer can benefit from it on its own or with other resources that are readily available to the customer. The Company’s System sale arrangements may For arrangements that contain multiple performance obligations, revenue is allocated to each performance obligation based on its relative estimated standalone selling price. When available, standalone selling prices are based on observable prices at which the Company separately sells the products or services; however due to limited sales to date, standalone selling prices generally are not not The Company recognizes revenues as the performance obligations are satisfied by transferring control of the product or service to a customer. The Company generally recognizes revenue for the performance obligations as follows: • System sales. For Systems and System components sold directly to end customers (including those arising from System purchases under lease rights to purchase), revenue is recognized when the Company transfers control to the customer, which is generally at the point when acceptance occurs that indicates customer acknowledgment of delivery or installation, depending on the terms of the arrangement. For Systems sold through distributors, for which distributors are responsible for installation, revenue is recognized generally at the time of shipment. The Company’s System arrangements generally do not one not • Instruments and accessories. Revenue from sales of instruments and accessories is recognized when control is transferred to the customers, which generally occurs at the time of shipment, but also occurs at the time of delivery depending on the customer arrangement. • Service. Service revenue is recognized ratably over the term of the service period as the customers benefit from the service throughout the service period. Revenue related to services performed on a time-and-materials basis is recognized when performed. The following table presents revenue disaggregated by type and geography: Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (in thousands) (in thousands) U.S. Systems $ 91 $ 45 $ 184 $ 75 Instruments and accessories 79 7 141 67 Services 104 103 202 171 Total U.S. revenue 274 155 527 313 Outside of U.S. ("OUS") Systems 258 117 1,430 127 Instruments and accessories 268 146 645 288 Services 302 237 583 527 Total OUS revenue 828 500 2,658 942 Total Systems 349 162 1,614 202 Instruments and accessories 347 153 786 355 Services 406 340 785 698 Total revenue $ 1,102 $ 655 $ 3,185 $ 1,255 The Company recognizes sales by geographic area based on the country in which the customer is based. Operating lease revenue from Senhance System Leasing is included as Systems in the above table and was approximately $0.3 million and $0.1 million in the three June 30, 2021 2020, six June 30, 2021 2020, Transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which the revenue has not June 30, 2021 December 31, 2020, The Company invoices its customers based on the billing schedules in its sales arrangements. Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative selling price of the related performance obligations and the contractual billing terms in the arrangements. Contract assets are included in accounts receivable and totaled $0.1 million and $0.1 million as of June 30, 2021 December 31, 2020, not three June 30, 2021 2020 six June 30, 2021 2020 June 30, 2021 one three In connection with assets recognized from the costs to obtain a contract with a customer, the Company determined that the sales incentive programs for its sales team do not not Senhance System Leasing The Company enters into lease arrangements with certain qualified customers. Revenue related to arrangements including lease elements are allocated to lease and non-lease elements based on their relative standalone selling prices. Lease elements generally include a Senhance System, while non-lease elements generally include instruments, accessories, and services. For some lease arrangements, the customers are provided with the right to purchase the leased System at some point during and/or at the end of the lease term. In some arrangements lease payments are based on the usage of the System. In determining whether a transaction should be classified as a sales-type, operating, or direct financing lease, the Company considers the following terms at lease commencement: ( 1 2 3 4 5 no June 30, 2021 Revenue related to lease elements from operating lease arrangements is generally recognized on a straight-line basis over the lease term or based upon System usage and is presented as product revenue. Revenue related to lease elements from operating lease arrangements was approximately $0.3 million and $0.1 million for the three June 30, 2021 2020, six June 30, 2021 2020, Cost of Revenue Cost of revenue consists of contract manufacturing, materials, labor, and manufacturing overhead incurred internally to produce the products. Shipping and handling costs incurred by the Company are included in cost of revenue. During the three June 30, 2021 2020, six June 30, 2021 2020, Research and Development Costs Research and development expenses primarily consist of engineering, product development and regulatory expenses, incurred in the design, development, testing and enhancement of our products. Research and development costs are expensed as incurred. Stock-Based Compensation The Company recognizes expenses for share-based awards exchanged for services rendered equal to the estimated fair value of these awards over the requisite service period. The Company recognizes as expense, the grant-date fair value of stock options and other stock-based compensation issued to employees and non-employee directors over the requisite service periods, which are typically the vesting periods. The Company uses the Black-Scholes-Merton model to estimate the fair value of our stock options. The volatility assumption used in the Black-Scholes-Merton model is based on the Company’s historical volatility. The expected term of options granted has been determined based upon the simplified method, because the Company does not not not The fair value of restricted stock units is determined by the market price of the Company’s common stock on the date of grant. The Company records as expense the fair value of stock-based compensation awards, including stock options and restricted stock units. Compensation expense for stock-based compensation was approximately $1.8 million and $1.9 million for the three June 30, 2021 2020, six June 30, 2021 2020, Income Taxes The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets or liabilities for the temporary differences between financial reporting and tax basis of the Company’s assets and liabilities, and for tax carryforwards at enacted statutory rates in effect for the years in which the asset or liability is expected to be realized. The effect on deferred taxes of a change in tax rates is recognized in income during the period that includes the enactment date. In addition, valuation allowances are established when necessary to reduce deferred tax assets and liabilities to the amounts expected to be realized. The Company has elected to account for global intangible low-taxed income (“GILTI”) as a period expense in the year the tax is incurred. The Company recognizes the financial statement benefit of an income tax position only after determining that the relevant taxing authority would more likely than not not 50% Tax regulations within each jurisdiction are subject to the interpretation of the related tax laws and regulations and require application of significant judgment. The Company is subject to U.S. federal and various state, local and foreign jurisdictions. Due to the Company’s net operating loss carryforwards, the Company may Comprehensive Loss Comprehensive loss is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Segments The Company operates in one business segment—the research, development and sale of medical device robotics to improve minimally invasive surgery. The Company’s chief operating decision maker (determined to be the Chief Executive Officer) does not Approximately 77% and 27% of the Company’s total consolidated assets are located within the U.S. as of June 30, 2021 December 31, 2020, June 30, 2021 December 31, 2020, June 30, 2021 December 31, 2020, June 30, 2021 December 31, 2020, three June 30, 2021 2020, six June 30, 2021 2020, Impact of Recently Issued Accounting Standards In December 2019, 2019 12, Simplifying the Accounting for Income Taxes 2019 12 740, Income Tax 2019 12 January 1, 2021; not In June 2016, 2016 13, Financial Instruments-Credit Losses (Topic 326 December 15, 2022, not In August 2020, 2020 06 Debt Debt with Conversion and Other Options (Subtopic 470 20 Contracts in Entity s Own Equity (subtopic 815 40 December 15, 2023, The Company has evaluated all other issued and unadopted ASUs and believes the adoption of these standards will not

Note 3 - Fair Value

Note 3 - Fair Value	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Fair Value Disclosures [Text Block]	3. Fair Value The Company held certain assets and liabilities that are required to be measured at fair value on a recurring basis. These assets and liabilities include cash and cash equivalents, restricted cash, contingent consideration and warrant liabilities. ASC 820 10 three one three 1, 2, 1, 3, not 1, 2, 3 three six June 30, 2021 2020. For assets and liabilities recorded at fair value, it is the Company’s policy to maximize the use of observable inputs and minimize the use of unobservable inputs when developing fair value measurements, in accordance with the fair value hierarchy. Fair value measurements for assets and liabilities where there exists limited or no may not may As prescribed by U.S. GAAP, the Company groups assets and liabilities at fair value in three 1 2 The determination of where an asset or liability falls in the hierarchy requires significant judgment. The Company evaluates its hierarchy disclosures and based on various factors, it is possible that an asset or liability may The carrying values of accounts receivable, other current assets, accounts payable, and certain accrued expenses as of June 30, 2021 December 31, 2020 December 31, 2020, The following are the major categories of assets and liabilities measured at fair value on a recurring basis as of June 30, 2021 December 31, 2020, 1 2 3 June 30, 2021 (in thousands) Description Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Assets measured at fair value Cash and cash equivalents $ 157,078 $ - $ - $ 157,078 Restricted cash 1,045 - - 1,045 Total assets measured at fair value $ 158,123 $ - $ - $ 158,123 Liabilities measured at fair value Contingent consideration $ - $ - $ 4,671 $ 4,671 Total liabilities measured at fair value $ - $ - $ 4,671 $ 4,671 December 31, 2020 (in thousands) Description Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Assets measured at fair value Cash and cash equivalents $ 16,363 $ - $ - $ 16,363 Restricted cash 1,166 - - 1,166 Total assets measured at fair value $ 17,529 $ - $ - $ 17,529 Liabilities measured at fair value Contingent consideration $ - $ - $ 3,936 $ 3,936 Warrant liabilities - - 255 255 Total liabilities measured at fair value $ - $ - $ 4,191 $ 4,191 The Company’s financial liabilities consisted of contingent consideration payable to Sofar related to the Senhance Acquisition in September 2015. 3 three six June 30, 2021, three six June 30, 2020, On April 28, 2017, October 31, 2017. December 31, 2020, first 2021. The final remeasurement upon exercise of the Series B warrants was on February 8, 2021 June 30, 2021. six June 30, 2021 2020 six June 30, 2021 three June 30, 2021. three June 30, 2020 December 31, Series B Warrants 2020 Valuation methodology Black-Scholes-Merton Term (years) 1.32 Risk free rate 0.10 % Dividends - Volatility 150.97 % Share price $ 0.63 The following table presents quantitative information about the inputs and valuation methodologies used for the Company’s fair value measurements for contingent consideration as of June 30, 2021 December 31, 2020: Methodology Unobservable Input 2021 2020 Contingent consideration Probability weighted income approach Milestone dates 2025 to 2029 2024 to 2029 Discount rate 9.0% 9.50% Volatility 74.0% 71.0% The following table summarizes the change in fair value, as determined by Level 3 six June 30, 2021: Fair Value Measurement at Reporting Date (Level 3) (in thousands) Common stock warrants Contingent consideration Balance at December 31, 2020 $ 255 $ 3,936 Exercise of warrants (2,236 ) - Change in fair value 1,981 735 Balance at June 30, 2021 $ - $ 4,671 Current portion $ - $ - Long-term portion - 4,671 Balance at June 30, 2021 $ - $ 4,671

Note 4 - Inventories

Note 4 - Inventories	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Inventory Disclosure [Text Block]	4. Inventories The components of inventories are as follows: June 30, 2021 December 31, 2020 (in thousands) Finished goods $ 13,238 $ 10,749 Raw materials 5,875 8,098 Total inventories $ 19,113 $ 18,847 Current portion $ 12,523 $ 10,034 Long-term portion 6,590 8,813 Total inventories $ 19,113 $ 18,847 During the three six June 30, 2021, three six June 30, 2020.

Note 5 - Intellectual Property

Note 5 - Intellectual Property	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Intangible Assets Disclosure [Text Block]	5. Intellectual Property The components of gross intellectual property, accumulated amortization, and net intellectual property as of June 30, 2021 December 31, 2020 June 30, 2021 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (55,755 ) $ 2,601 $ 15,684 Technology and patents purchased 400 (185 ) 44 259 Total intellectual property $ 69,238 $ (55,940 ) $ 2,645 $ 15,943 December 31, 2020 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (51,734 ) $ 4,872 $ 21,976 Technology and patents purchased 400 (168 ) 59 291 Total intellectual property $ 69,238 $ (51,902 ) $ 4,931 $ 22,267 The weighted average remaining useful life of the developed technology and technology and patents purchased was 1.8 years and 5.8 years, respectively as of June 30, 2021.

Note 6 - Income Taxes

Note 6 - Income Taxes	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Income Tax Disclosure [Text Block]	6. Income Taxes Income taxes have been accounted for using the asset and liability method in accordance with ASC 740 December 31, 2021. not three June 30, 2021 2020 six June 30, 2021 2020 The Company incurred losses for the three six June 30, 2021 December 31, 2021. not Income tax benefit on the condensed consolidated statement of operations and comprehensive loss is comprised of deferred tax benefit and current tax expense (benefit). The deferred tax benefit during the three June 30, 2021 2020, six June 30, 2021 2020, three June 30, 2021 2020, six June 30, 2021 2020, At June 30, 2021, The FASB Staff Q&A, Topic 740, No. 5, not 2021; no three six June 30, 2021 2020.

Note 7 - Notes Payable - Payrol

Note 7 - Notes Payable - Payroll Protection Program	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Debt Disclosure [Text Block]	7. Notes Payable Payroll Protection Program The CARES Act was passed in the United States and signed into law on March 7, 2020 June 5, 2020 April 27, 2020, April 18, 2020 ( The Promissory Note has a two April 27, 2022, may 60% may not 10 24 twelve The Company submitted its application for forgiveness of the Promissory Note in full to the Lender on February 10, 2021. June 10, 2021, three six June 30, 2021

Note 8 - Equity Offerings

Note 8 - Equity Offerings	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Stockholders' Equity Note Disclosure [Text Block]	8. Equity Offerings On August 12, 2019, “2019 “2019 2019 3. 2019 December 31, 2019, December 31, 2020. On October 9, 2020, may 2019 “2020 3, February 10, 2020. The following table summarizes the total sales under the 2020 six June 30, 2021 ( For the Six Months Ended June 30, 2021 Total shares of common stock sold 19,120,037 Average price per share $ 1.47 Gross proceeds $ 28,100 Commissions earned by Cantor $ 843 Net proceeds $ 27,257 On May 19, 2021, “2021 May 19, 2021, “2021 The following table summarizes the total sales under the 2021 six June 30, 2021 ( For the Six Months Ended June 30, 2021 Total shares of common stock sold 331,811 Average price per share $ 3.47 Gross proceeds $ 1,152 Commissions earned by Agents $ 34 Net proceeds $ 1,118 On March 10, 2020, March 2020 one one one first one one fifth one one one one no not The shares of Series A Preferred Stock rank on par with the shares of the common stock, in each case, as to dividend rights and distributions of assets upon liquidation, dissolution or winding up of the Company. With certain statutory exceptions, as described in the Series A Preferred Stock Certificate of Designation, the shares of Series A Preferred Stock have no one December 31, 2020. June 30, 2020. December 31, 2020. The net proceeds to the Company from the March 2020 June 30, 2020. 4.9 December 31, 2020, 3, May 2020. 1 May 27, 2020. On July 6, 2020, On January 12, 2021, On January 29, 2021, February 1, 2021, During the six June 30, 2021,

Note 9 - Basic and Diluted Net

Note 9 - Basic and Diluted Net Loss Per Share	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Earnings Per Share [Text Block]	9. Basic and Diluted Net Loss per Share Basic net loss per common share is computed by dividing net loss attributable to common stockholders by the weighted average number of common shares outstanding during the period. Diluted net loss per common share is computed giving effect to all potential dilutive common shares that were outstanding during the period when the effect is dilutive. Potential dilutive common shares consist of incremental shares issuable upon exercise of stock options, restricted stock units, warrants and preferred stock. For the six June 30, 2020, No six June 30, 2021 2020 Potential common shares not June 30, 2021 2020 Stock options 4,279,335 4,278,967 Stock warrants 1,016,383 46,461,630 Nonvested restricted stock units 1,768,861 3,036,176 Total 7,064,579 53,776,773

Note 10 - Commitments and Conti

Note 10 - Commitments and Contingencies	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	10. Commitments and Contingencies Contingent Consideration On September 21, 2015, 2016, June 30, 2021 €25.0 Legal Proceedings No three six June 30, 2021 2020. Operating Leases Many of the Company’s leases include base rental periods coupled with options to renew or terminate the lease, generally at the Company’s discretion. In evaluating the lease term, the Company considers whether renewal is reasonably certain. To the extent a significant economic incentive exists to renew the lease, the option is included within the lease term. Based on the Company’s leases, renewal options generally do not June 30, 2021 December 31, 2020, As of June 30, 2021, three June 30, 2021 2020 six June 30, 2021 2020 June 30, 2021 three June 30, 2021 2020, six June 30, 2021 2020, The following table presents the minimum lease payments as of June 30, 2021 ( Fiscal Year Remainder of 2021 $ 515 2022 851 2023 585 2024 484 2025 487 Thereafter 2,932 Total minimum lease payments $ 5,854 Less: Amount of lease payments representing interest (1,528 ) Present value of future minimum lease payments $ 4,326 License and Supply Agreements As part of the Company’s acquisition of the Senhance System in 2015, not twelve 2021, 2022, 2023, 2024, 2027.

Significant Accounting Policies

Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2021
Accounting Policies [Abstract]
Basis of Accounting, Policy [Policy Text Block]	Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and include the accounts of the Company and its direct and indirect wholly owned subsidiaries. The Company has prepared the accompanying unaudited interim condensed consolidated financial statements in accordance with the instructions to Form 10 not 10 10 not may 2020 10 not
Substantial Doubt about Going Concern [Policy Text Block]	Liquidity The Company had an accumulated deficit of $753.4 million and working capital of $165.7 million as of June 30, 2021. not may The Company believes the COVID- 19 In the first 2021, January 2021 January 2021 2020 “2020 six June 30, 2021 In the second 2021, 2021 three June 30, 2021. As of June 30, 2021, While the Company believes that its existing cash and cash equivalents as of June 30, 2021 12 may may 2021
Risk And Uncertainties, Policy [Policy Text Block]	Risk and Uncertainties The Company is subject to risks similar to other similarly sized companies in the medical device industry. These risks include, without limitation: potential negative impacts on the Company's operations caused by the COVID- 19
Use of Estimates, Policy [Policy Text Block]	Use of Estimates The preparation of 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 the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Significant items subject to such estimates and assumptions include impairment considerations for long- term intangible assets, fair value estimates related to contingent consideration, warrant liabilities, stock compensation expense, revenue recognition, accounts receivable reserves, excess and obsolete inventory reserves, inventory classification between current and non-current, measurement of lease liabilities and corresponding ROU assets, and deferred tax asset valuation allowances. The COVID- 19 19 19 19 19
Consolidation, Policy [Policy Text Block]	Principles of Consolidation and Foreign Currency Considerations The accompanying Condensed Consolidated Financial Statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., SafeStitch LLC, Asensus International, Inc., Asensus Surgical Italia S.r.l., Asensus Surgical Europe S.à.r.l., Asensus Surgical Taiwan Ltd., Asensus Surgical Japan K.K., Asensus Surgical Israel Ltd., Asensus Surgical Netherlands B.V., and Asensus Surgical Canada, Inc. All inter-company accounts and transactions have been eliminated in consolidation. The functional currency of the Company’s operational foreign subsidiaries is predominantly the Euro. The assets and liabilities of the Company’s foreign subsidiaries are translated into U.S. dollars at exchange rates in effect at the balance sheet date. Income and expense items are translated at the average exchange rates prevailing during the period. The cumulative translation effect for a subsidiary using a functional currency other than the U.S. dollar is included in accumulated other comprehensive income or loss as a separate component of stockholders’ equity. The Company’s intercompany accounts are denominated in the functional currency of the foreign subsidiary. Gains and losses resulting from the remeasurement of intercompany receivables that the Company considers to be of a long-term investment nature are recorded as a cumulative translation adjustment in accumulated other comprehensive income or loss as a separate component of stockholders’ equity, while gains and losses resulting from the remeasurement of intercompany receivables from a foreign subsidiary for which the Company anticipates settlement in the foreseeable future are recorded in the condensed consolidated statements of operations and comprehensive loss. The net gains and losses included in net loss in the condensed consolidated statements of operations and comprehensive loss for the three six June 30, 2021 2020 not
Cash and Cash Equivalents, Restricted Cash and Cash Equivalents, Policy [Policy Text Block]	Cash and Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with original maturities of 90 Restricted cash as of June 30, 2021 December 31, 2020
Concentration Risk, Credit Risk, Policy [Policy Text Block]	Concentrations and Credit Risk The Company’s principal financial instruments subject to potential concentration of credit risk are cash and cash equivalents, including amounts held in money market accounts. The Company places cash deposits with a federally insured financial institution. The Company maintains its cash at banks and financial institutions it considers to be of high credit quality; however, the Company’s domestic cash deposits may may not not not The Company’s accounts receivable are derived from sales and leases to customers located throughout the world. The Company evaluates its customers’ financial condition and, generally, requires no no three six June 30, 2021 2020. June 30, 2021. seven December 31, 2020. three June 30, 2021 three June 30, 2020. six June 30, 2021 six June 30, 2020.
Receivable [Policy Text Block]	Accounts Receivable Accounts receivable are recorded at net realizable value, which includes an allowance for estimated uncollectible accounts. The allowance for uncollectible accounts was determined on a customer specific basis based on deemed collectability. The allowance for doubtful accounts was $1.7 million and $1.8 million as of June 30, 2021 December 31, 2020,
Inventory, Policy [Policy Text Block]	Inventories Inventories are stated at the lower of cost (determined on a first first not Any inventory on hand at the measurement date in excess of the Company's current requirements based on anticipated levels of sales is classified as long-term on the Company's condensed consolidated balance sheets. The Company's classification of long-term inventory requires it to estimate the portion of on hand inventory that can be realized over the upcoming twelve
Goodwill and Intangible Assets, Policy [Policy Text Block]	Intellectual Property Intellectual property consists of purchased patent rights and developed technology acquired as part of previous business acquisitions. Amortization of the patent rights is recorded using the straight-line method over the estimated useful life of the patents of 10 years. Amortization of the developed technology is recorded using the straight-line method over the estimated useful life of 5 to 7 years. The Company periodically evaluates intellectual property for impairment whenever events or changes in circumstances indicate that the carrying amount may not three six June 30, 2021 2020.
Property, Plant and Equipment, Policy [Policy Text Block]	Property and Equipment Property and equipment consists primarily of operating lease Senhance System assets, machinery, manufacturing equipment, demonstration equipment, computer equipment, furniture, and leasehold improvements, which are recorded at cost less accumulated depreciation. Depreciation is recorded using the straight-line method over the estimated useful lives of the assets as follows: Operating lease assets – Senhance System leasing (in years) 5 Machinery, manufacturing and demonstration equipment (in years) 3-5 Computer equipment (in years) 3 Furniture (in years) 5 Leasehold improvements Lesser of lease term or 3 to 10 years Upon retirement or sale, the cost of assets disposed of and the related accumulated depreciation and amortization are removed from the accounts and any resulting gain or loss is credited or charged to operations. Repairs and maintenance costs are expensed as incurred. The Company reviews its property and equipment assets for possible impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not not three six June 30, 2021 2020.
Debt, Policy [Policy Text Block]	Notes Payable Payroll Protection Program The Company’s policy is to account for forgivable loans received through the U.S. Small Business Administration (the “SBA”) under the CARES Act Payroll Protection Program (“PPP”), as debt in accordance with ASC 470, June 10, 2021,
Contingent Consideration [Policy Text Block]	Contingent Consideration Contingent consideration is recorded as a liability and is the estimate of the fair value of potential milestone payments related to business acquisitions. Contingent consideration is measured at fair value using a discounted cash flow model utilizing significant unobservable inputs including the probability of achieving each of the potential milestones, future Euro-to-USD exchange rates, and an estimated discount rate associated with the risks of the expected cash flows attributable to the various milestones. Significant increases or decreases in any of the probabilities of success or changes in expected achievement of any of these milestones would result in a significantly higher or lower fair value of these milestones, respectively, and commensurate changes to the associated liability. The contingent consideration is revalued at each reporting period and changes in fair value are recognized in the condensed consolidated statements of operations and comprehensive loss. On September 21, 2015, 2016, June 30, 2021 € 25.0
Warrant Liabilities [Policy Text Block]	Warrant Liabilities The Company’s Series B Warrants (see Note 8 3 first 2021.
Revenue [Policy Text Block]	Revenue Recognition The Company’s revenue consists of product revenue resulting from the sale and lease of Systems, System components, instruments and accessories, and service revenue. The Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and the customer, the rights of the parties are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company's revenues are measured based on consideration specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government authorities. The Company’s System sale arrangements generally include a five first four The Company’s System sale arrangements generally contain multiple products and services. For these consolidated sale arrangements, the Company accounts for individual products and services as separate performance obligations if they are distinct, which is if a product or service is separately identifiable from other items in the consolidated package, and if a customer can benefit from it on its own or with other resources that are readily available to the customer. The Company’s System sale arrangements may For arrangements that contain multiple performance obligations, revenue is allocated to each performance obligation based on its relative estimated standalone selling price. When available, standalone selling prices are based on observable prices at which the Company separately sells the products or services; however due to limited sales to date, standalone selling prices generally are not not The Company recognizes revenues as the performance obligations are satisfied by transferring control of the product or service to a customer. The Company generally recognizes revenue for the performance obligations as follows: • System sales. For Systems and System components sold directly to end customers (including those arising from System purchases under lease rights to purchase), revenue is recognized when the Company transfers control to the customer, which is generally at the point when acceptance occurs that indicates customer acknowledgment of delivery or installation, depending on the terms of the arrangement. For Systems sold through distributors, for which distributors are responsible for installation, revenue is recognized generally at the time of shipment. The Company’s System arrangements generally do not one not • Instruments and accessories. Revenue from sales of instruments and accessories is recognized when control is transferred to the customers, which generally occurs at the time of shipment, but also occurs at the time of delivery depending on the customer arrangement. • Service. Service revenue is recognized ratably over the term of the service period as the customers benefit from the service throughout the service period. Revenue related to services performed on a time-and-materials basis is recognized when performed. The following table presents revenue disaggregated by type and geography: Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (in thousands) (in thousands) U.S. Systems $ 91 $ 45 $ 184 $ 75 Instruments and accessories 79 7 141 67 Services 104 103 202 171 Total U.S. revenue 274 155 527 313 Outside of U.S. ("OUS") Systems 258 117 1,430 127 Instruments and accessories 268 146 645 288 Services 302 237 583 527 Total OUS revenue 828 500 2,658 942 Total Systems 349 162 1,614 202 Instruments and accessories 347 153 786 355 Services 406 340 785 698 Total revenue $ 1,102 $ 655 $ 3,185 $ 1,255 The Company recognizes sales by geographic area based on the country in which the customer is based. Operating lease revenue from Senhance System Leasing is included as Systems in the above table and was approximately $0.3 million and $0.1 million in the three June 30, 2021 2020, six June 30, 2021 2020, Transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which the revenue has not June 30, 2021 December 31, 2020, The Company invoices its customers based on the billing schedules in its sales arrangements. Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative selling price of the related performance obligations and the contractual billing terms in the arrangements. Contract assets are included in accounts receivable and totaled $0.1 million and $0.1 million as of June 30, 2021 December 31, 2020, not three June 30, 2021 2020 six June 30, 2021 2020 June 30, 2021 one three In connection with assets recognized from the costs to obtain a contract with a customer, the Company determined that the sales incentive programs for its sales team do not not
Revenue Recognition Leases, Operating [Policy Text Block]	Senhance System Leasing The Company enters into lease arrangements with certain qualified customers. Revenue related to arrangements including lease elements are allocated to lease and non-lease elements based on their relative standalone selling prices. Lease elements generally include a Senhance System, while non-lease elements generally include instruments, accessories, and services. For some lease arrangements, the customers are provided with the right to purchase the leased System at some point during and/or at the end of the lease term. In some arrangements lease payments are based on the usage of the System. In determining whether a transaction should be classified as a sales-type, operating, or direct financing lease, the Company considers the following terms at lease commencement: ( 1 2 3 4 5 no June 30, 2021 Revenue related to lease elements from operating lease arrangements is generally recognized on a straight-line basis over the lease term or based upon System usage and is presented as product revenue. Revenue related to lease elements from operating lease arrangements was approximately $0.3 million and $0.1 million for the three June 30, 2021 2020, six June 30, 2021 2020,
Cost of Goods and Service [Policy Text Block]	Cost of Revenue Cost of revenue consists of contract manufacturing, materials, labor, and manufacturing overhead incurred internally to produce the products. Shipping and handling costs incurred by the Company are included in cost of revenue. During the three June 30, 2021 2020, six June 30, 2021 2020,
Research and Development Expense, Policy [Policy Text Block]	Research and Development Costs Research and development expenses primarily consist of engineering, product development and regulatory expenses, incurred in the design, development, testing and enhancement of our products. Research and development costs are expensed as incurred.
Share-based Payment Arrangement [Policy Text Block]	Stock-Based Compensation The Company recognizes expenses for share-based awards exchanged for services rendered equal to the estimated fair value of these awards over the requisite service period. The Company recognizes as expense, the grant-date fair value of stock options and other stock-based compensation issued to employees and non-employee directors over the requisite service periods, which are typically the vesting periods. The Company uses the Black-Scholes-Merton model to estimate the fair value of our stock options. The volatility assumption used in the Black-Scholes-Merton model is based on the Company’s historical volatility. The expected term of options granted has been determined based upon the simplified method, because the Company does not not not The fair value of restricted stock units is determined by the market price of the Company’s common stock on the date of grant. The Company records as expense the fair value of stock-based compensation awards, including stock options and restricted stock units. Compensation expense for stock-based compensation was approximately $1.8 million and $1.9 million for the three June 30, 2021 2020, six June 30, 2021 2020,
Income Tax, Policy [Policy Text Block]	Income Taxes The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets or liabilities for the temporary differences between financial reporting and tax basis of the Company’s assets and liabilities, and for tax carryforwards at enacted statutory rates in effect for the years in which the asset or liability is expected to be realized. The effect on deferred taxes of a change in tax rates is recognized in income during the period that includes the enactment date. In addition, valuation allowances are established when necessary to reduce deferred tax assets and liabilities to the amounts expected to be realized. The Company has elected to account for global intangible low-taxed income (“GILTI”) as a period expense in the year the tax is incurred. The Company recognizes the financial statement benefit of an income tax position only after determining that the relevant taxing authority would more likely than not not 50% Tax regulations within each jurisdiction are subject to the interpretation of the related tax laws and regulations and require application of significant judgment. The Company is subject to U.S. federal and various state, local and foreign jurisdictions. Due to the Company’s net operating loss carryforwards, the Company may
Comprehensive Income, Policy [Policy Text Block]	Comprehensive Loss Comprehensive loss is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources.
Segment Reporting, Policy [Policy Text Block]	Segments The Company operates in one business segment—the research, development and sale of medical device robotics to improve minimally invasive surgery. The Company’s chief operating decision maker (determined to be the Chief Executive Officer) does not Approximately 77% and 27% of the Company’s total consolidated assets are located within the U.S. as of June 30, 2021 December 31, 2020, June 30, 2021 December 31, 2020, June 30, 2021 December 31, 2020, June 30, 2021 December 31, 2020, three June 30, 2021 2020, six June 30, 2021 2020,
New Accounting Pronouncements, Policy [Policy Text Block]	Impact of Recently Issued Accounting Standards In December 2019, 2019 12, Simplifying the Accounting for Income Taxes 2019 12 740, Income Tax 2019 12 January 1, 2021; not In June 2016, 2016 13, Financial Instruments-Credit Losses (Topic 326 December 15, 2022, not In August 2020, 2020 06 Debt Debt with Conversion and Other Options (Subtopic 470 20 Contracts in Entity s Own Equity (subtopic 815 40 December 15, 2023, The Company has evaluated all other issued and unadopted ASUs and believes the adoption of these standards will not

Note 2 - Summary of Significa_2

Note 2 - Summary of Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Property Plant and Equipment Useful Life [Table Text Block]	Operating lease assets – Senhance System leasing (in years) 5 Machinery, manufacturing and demonstration equipment (in years) 3-5 Computer equipment (in years) 3 Furniture (in years) 5 Leasehold improvements Lesser of lease term or 3 to 10 years
Disaggregation of Revenue [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (in thousands) (in thousands) U.S. Systems $ 91 $ 45 $ 184 $ 75 Instruments and accessories 79 7 141 67 Services 104 103 202 171 Total U.S. revenue 274 155 527 313 Outside of U.S. ("OUS") Systems 258 117 1,430 127 Instruments and accessories 268 146 645 288 Services 302 237 583 527 Total OUS revenue 828 500 2,658 942 Total Systems 349 162 1,614 202 Instruments and accessories 347 153 786 355 Services 406 340 785 698 Total revenue $ 1,102 $ 655 $ 3,185 $ 1,255

Note 3 - Fair Value (Tables)

Note 3 - Fair Value (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Fair Value, Assets Measured on Recurring Basis [Table Text Block]	June 30, 2021 (in thousands) Description Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Assets measured at fair value Cash and cash equivalents $ 157,078 $ - $ - $ 157,078 Restricted cash 1,045 - - 1,045 Total assets measured at fair value $ 158,123 $ - $ - $ 158,123 Liabilities measured at fair value Contingent consideration $ - $ - $ 4,671 $ 4,671 Total liabilities measured at fair value $ - $ - $ 4,671 $ 4,671 December 31, 2020 (in thousands) Description Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Assets measured at fair value Cash and cash equivalents $ 16,363 $ - $ - $ 16,363 Restricted cash 1,166 - - 1,166 Total assets measured at fair value $ 17,529 $ - $ - $ 17,529 Liabilities measured at fair value Contingent consideration $ - $ - $ 3,936 $ 3,936 Warrant liabilities - - 255 255 Total liabilities measured at fair value $ - $ - $ 4,191 $ 4,191
Fair Value Measurement Inputs and Valuation Techniques [Table Text Block]	December 31, Series B Warrants 2020 Valuation methodology Black-Scholes-Merton Term (years) 1.32 Risk free rate 0.10 % Dividends - Volatility 150.97 % Share price $ 0.63 Methodology Unobservable Input 2021 2020 Contingent consideration Probability weighted income approach Milestone dates 2025 to 2029 2024 to 2029 Discount rate 9.0% 9.50% Volatility 74.0% 71.0%
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]	Fair Value Measurement at Reporting Date (Level 3) (in thousands) Common stock warrants Contingent consideration Balance at December 31, 2020 $ 255 $ 3,936 Exercise of warrants (2,236 ) - Change in fair value 1,981 735 Balance at June 30, 2021 $ - $ 4,671 Current portion $ - $ - Long-term portion - 4,671 Balance at June 30, 2021 $ - $ 4,671

Note 4 - Inventories (Tables)

Note 4 - Inventories (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Inventory, Current [Table Text Block]	June 30, 2021 December 31, 2020 (in thousands) Finished goods $ 13,238 $ 10,749 Raw materials 5,875 8,098 Total inventories $ 19,113 $ 18,847 Current portion $ 12,523 $ 10,034 Long-term portion 6,590 8,813 Total inventories $ 19,113 $ 18,847

Note 5 - Intellectual Property

Note 5 - Intellectual Property (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Finite-Lived Intangible Assets [Table Text Block]	June 30, 2021 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (55,755 ) $ 2,601 $ 15,684 Technology and patents purchased 400 (185 ) 44 259 Total intellectual property $ 69,238 $ (55,940 ) $ 2,645 $ 15,943 December 31, 2020 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (51,734 ) $ 4,872 $ 21,976 Technology and patents purchased 400 (168 ) 59 291 Total intellectual property $ 69,238 $ (51,902 ) $ 4,931 $ 22,267

Note 8 - Equity Offerings (Tabl

Note 8 - Equity Offerings (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Sales Under Sales Agency Agreement [Table Text Block]	For the Six Months Ended June 30, 2021 Total shares of common stock sold 19,120,037 Average price per share $ 1.47 Gross proceeds $ 28,100 Commissions earned by Cantor $ 843 Net proceeds $ 27,257 For the Six Months Ended June 30, 2021 Total shares of common stock sold 331,811 Average price per share $ 3.47 Gross proceeds $ 1,152 Commissions earned by Agents $ 34 Net proceeds $ 1,118

Note 9 - Basic and Diluted Ne_2

Note 9 - Basic and Diluted Net Loss Per Share (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block]	June 30, 2021 2020 Stock options 4,279,335 4,278,967 Stock warrants 1,016,383 46,461,630 Nonvested restricted stock units 1,768,861 3,036,176 Total 7,064,579 53,776,773

Note 10 - Commitments and Con_2

Note 10 - Commitments and Contingencies (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Fiscal Year Remainder of 2021 $ 515 2022 851 2023 585 2024 484 2025 487 Thereafter 2,932 Total minimum lease payments $ 5,854 Less: Amount of lease payments representing interest (1,528 ) Present value of future minimum lease payments $ 4,326

Note 1 - Organization and Cap_2

Note 1 - Organization and Capitalization (Details Textual) - USD ($)	Jun. 30, 2021	May 19, 2021	Dec. 31, 2020
Common Stock, Par or Stated Value Per Share (in dollars per share)	$ 0.001		$ 0.001
The 2021 ATM Offering [Member]
Stock Offering Agreement, Maximum Share Value		$ 100,000,000
Common Stock, Par or Stated Value Per Share (in dollars per share)		$ 0.001

Note 2 - Summary of Significa_3

Note 2 - Summary of Significant Accounting Policies 1 (Details Textual) $ in Thousands, € in Millions	Jun. 10, 2021USD ($)	Jan. 29, 2021USD ($)	Jan. 12, 2021USD ($)	Jun. 30, 2021USD ($)	Mar. 31, 2021USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2021USD ($)	Jun. 30, 2021EUR (€)	Jun. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Retained Earnings (Accumulated Deficit), Ending Balance				$ (753,424)			$ (753,424)			$ (722,912)
Working Capital				165,700			165,700
Proceeds from Warrant Exercises							30,600
Cash and Cash Equivalents, at Carrying Value, Ending Balance				157,078			157,078			16,363
Restricted Cash and Cash Equivalents, Noncurrent, Total				1,000			1,000			1,200
Accounts Receivable, Allowance for Credit Loss, Ending Balance				1,700			1,700			1,800
Impairment of Intangible Assets, Finite-lived				0		$ 0	0		$ 0
Business Combination, Contingent Consideration, Liability, Total				4,671			$ 4,671			3,936
Period Of Service Sale Arrangement (Year)							5 years	5 years
Period of Service Sale Arrangement at Stated Service Price (Year)							4 years	4 years
Operating Lease, Lease Income, Total				300		100	$ 700		200
Revenue, Remaining Performance Obligation, Amount				3,200			3,200			3,100
Contract with Customer, Asset, after Allowance for Credit Loss, Current, Total				100			100			100
Contract with Customer, Liability, Revenue Recognized				200		400	400		600
Inventory Write-down				200		0	288		0
Share-based Payment Arrangement, Expense				1,800		1,900	$ 3,600		3,900
Number of Operating Segments							1	1
Assets, Total				212,004			$ 212,004			78,258
Non-US [Member]
Assets, Total				47,600			47,600			$ 56,800
Senhance Surgical Robotic System Acquisition[Member]
Business Combination, Contingent Consideration, Liability, Total				4,700			$ 4,700
Paycheck Protection Program CARES Act [Member]
Debt Instrument, Decrease, Forgiveness	$ 2,800
Minimum [Member] | Senhance Surgical Robotic System Acquisition[Member]
Business Combination Contingent Consideration Arrangements Target Revenue | €								€ 25
Patents [Member]
Finite-Lived Intangible Asset, Useful Life (Year)							10 years	10 years
Developed Technology Rights [Member] | Minimum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)							5 years	5 years
Developed Technology Rights [Member] | Maximum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)							7 years	7 years
Intellectual Property [Member]
Impairment of Intangible Assets, Finite-lived				$ 0		$ 0	$ 0		$ 0
Accounts Receivable [Member] | Customer Concentration Risk [Member] | Four Customers [Member]
Number of Major Customers							4	4
Concentration Risk, Percentage							59.00%	59.00%
Accounts Receivable [Member] | Customer Concentration Risk [Member] | Seven Customers [Member]
Number of Major Customers										7
Concentration Risk, Percentage										68.00%
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | Seven Customers [Member]
Number of Major Customers						7	4	4	9
Concentration Risk, Percentage						60.00%	54.00%	54.00%	65.00%
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | Five Customers [Member]
Number of Major Customers				5
Concentration Risk, Percentage				39.00%
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | UNITED STATES
Concentration Risk, Percentage				25.00%		24.00%	17.00%	17.00%	25.00%
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | Europe [Member]
Concentration Risk, Percentage				53.00%		56.00%	32.00%	32.00%	52.00%
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | Asia [Member]
Concentration Risk, Percentage				22.00%		20.00%	51.00%	51.00%	23.00%
Assets, Total [Member] | Geographic Concentration Risk [Member] | UNITED STATES
Concentration Risk, Percentage							77.00%	77.00%		27.00%
Assets, Total [Member] | Geographic Concentration Risk [Member] | Non-US [Member]
Concentration Risk, Percentage							23.00%	23.00%		73.00%
Long-lived Assets [Member] | Geographic Concentration Risk [Member] | UNITED STATES
Concentration Risk, Percentage							21.00%	21.00%		11.00%
Long-lived Assets [Member] | Geographic Concentration Risk [Member] | ITALY
Concentration Risk, Percentage							37.00%	37.00%		48.00%
Long-lived Assets [Member] | Geographic Concentration Risk [Member] | SWITZERLAND
Concentration Risk, Percentage							40.00%	40.00%		41.00%
Public Offering [Member]
Proceeds from Issuance of Common Stock		$ 79,600			$ 73,400
Registered Direct Offering [Member]
Proceeds from Issuance of Common Stock			$ 28,600		28,600
ATM Offering [Member]
Proceeds from Issuance of Common Stock				$ 1,000	$ 27,300

Note 2 - Summary of Significa_4

Note 2 - Summary of Significant Accounting Policies 2 (Details Textual) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2021-07-01	Jun. 30, 2021
Minimum [Member]
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Period (Year)	1 year
Maximum [Member]
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Period (Year)	3 years

Note 2 - Summary of Significa_5

Note 2 - Summary of Significant Accounting Policies - Estimated Useful Lives of Assets (Details)	6 Months Ended
	Jun. 30, 2021
Operating Lease Assets [Member]
Property and equipment, estimated useful lives (Year)	5 years
Machinery, Manufacturing and Demonstration Equipment [Member] | Minimum [Member]
Property and equipment, estimated useful lives (Year)	3 years
Machinery, Manufacturing and Demonstration Equipment [Member] | Maximum [Member]
Property and equipment, estimated useful lives (Year)	5 years
Computer Equipment [Member]
Property and equipment, estimated useful lives (Year)	3 years
Furniture and Fixtures [Member]
Property and equipment, estimated useful lives (Year)	5 years

Note 2 - Summary of Significa_6

Note 2 - Summary of Significant Accounting Policies - Revenue Disaggregated by Type and Geography (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Revenue	$ 1,102	$ 655	$ 3,185	$ 1,255
Systems [Member]
Revenue	349	162	1,614	202
Instruments and Accessories [Member]
Revenue	347	153	786	355
Service [Member]
Revenue	406	340	785	698
UNITED STATES
Revenue	274	155	527	313
UNITED STATES | Systems [Member]
Revenue	91	45	184	75
UNITED STATES | Instruments and Accessories [Member]
Revenue	79	7	141	67
UNITED STATES | Service [Member]
Revenue	104	103	202	171
Non-US [Member]
Revenue	828	500	2,658	942
Non-US [Member] | Systems [Member]
Revenue	258	117	1,430	127
Non-US [Member] | Instruments and Accessories [Member]
Revenue	268	146	645	288
Non-US [Member] | Service [Member]
Revenue	$ 302	$ 237	$ 583	$ 527

Note 3 - Fair Value (Details Te

Note 3 - Fair Value (Details Textual) - USD ($) $ / shares in Units, $ in Thousands	Apr. 28, 2017	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability		$ 478	$ 212	$ 735	$ 1,268
Number of Units Sold (in shares)	24,900,000
Number of Shares in Each Unit (in shares)	0.077
Shares Issued, Price Per Share (in dollars per share)	$ 1
Fair Value Adjustment of Warrants		$ 0	$ 114	$ 1,981	$ 269
Series A Warrant [Member]
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares)	0.077
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share)	$ 13
Series B Warrant [Member]
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares)	0.058
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share)	$ 13	$ 0.35		$ 0.35		$ 0.35
Share-based Compensation Arrangement by Share-based Payment Award, Non-Option Equity Instruments, Outstanding, Number, Ending Balance (in shares)						567,660

Note 3 - Fair Value - Summary o

Note 3 - Fair Value - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Cash and cash equivalents	$ 157,078	$ 16,363
Restricted cash	1,045	1,166
Total assets measured at fair value	158,123	17,529
Contingent consideration	4,671	3,936
Total liabilities measured at fair value	4,671	4,191
Warrant liabilities	0	255
Fair Value, Inputs, Level 1 [Member]
Cash and cash equivalents	157,078	16,363
Restricted cash	1,045	1,166
Total assets measured at fair value	158,123	17,529
Contingent consideration	0	0
Total liabilities measured at fair value	0	0
Warrant liabilities		0
Fair Value, Inputs, Level 2 [Member]
Cash and cash equivalents	0	0
Restricted cash	0	0
Total assets measured at fair value	0	0
Contingent consideration	0	0
Total liabilities measured at fair value	0	0
Warrant liabilities		0
Fair Value, Inputs, Level 3 [Member]
Cash and cash equivalents	0	0
Restricted cash	0	0
Total assets measured at fair value	0	0
Contingent consideration	4,671	3,936
Total liabilities measured at fair value	$ 4,671	4,191
Warrant liabilities		$ 255

Note 3 - Fair Value - Quantitat

Note 3 - Fair Value - Quantitative Information about Inputs and Valuation Methodologies Used for Fair Value Measurements Classification (Details)	Jun. 30, 2021	Dec. 31, 2020yr$ / shares
Series B Warrant [Member]
Share price (in dollars per share) | $ / shares		$ 0.63
Measurement Input, Expected Term [Member] | Series B Warrant [Member]
Warrants, measurement input (Year) | yr		1.32
Measurement Input, Risk Free Interest Rate [Member] | Series B Warrant [Member]
Warrants, measurement input (Year)		0.0010
Measurement Input, Price Volatility [Member] | Series B Warrant [Member]
Warrants, measurement input (Year)		1.5097
Measurement Input, Expected Dividend Payment [Member] | Series B Warrant [Member]
Warrants, measurement input (Year)		0
Senhance Surgical Robotic System Acquisition[Member] | Fair Value, Inputs, Level 3 [Member] | Measurement Input, Discount Rate [Member]
Contingent consideration, measurement input	0.090	0.0950
Senhance Surgical Robotic System Acquisition[Member] | Fair Value, Inputs, Level 3 [Member] | Measurement Input, Price Volatility [Member]
Contingent consideration, measurement input	0.740	0.710
Senhance Surgical Robotic System Acquisition[Member] | Fair Value, Inputs, Level 3 [Member] | Minimum [Member] | Milestone Date, Year [Member]
Contingent consideration, measurement input	2,025	2,024
Senhance Surgical Robotic System Acquisition[Member] | Fair Value, Inputs, Level 3 [Member] | Maximum [Member] | Milestone Date, Year [Member]
Contingent consideration, measurement input	2,029	2,029

Note 3 - Fair Value - Summary_2

Note 3 - Fair Value - Summary of Change in Fair Value for Warrants and Contingent Consideration (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2021USD ($)
Warrant [Member]
Balance	$ 255
Exercise of warrants	(2,236)
Change in fair value	1,981
Balance	0
Current portion	0
Long-term portion	0
Balance	0
Contingent Consideration [Member]
Balance	3,936
Exercise of warrants	0
Change in fair value	735
Balance	4,671
Current portion	0
Long-term portion	4,671
Balance	$ 4,671

Note 4 - Inventories (Details T

Note 4 - Inventories (Details Textual) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Inventory Write-down	$ 200	$ 0	$ 288	$ 0
Systems [Member]
Inventory Write-down	$ 200	$ 0	$ 300	$ 0

Note 4 - Inventories - Componen

Note 4 - Inventories - Components of Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Finished goods	$ 13,238	$ 10,749
Raw materials	5,875	8,098
Total inventories	19,113	18,847
Current portion	12,523	10,034
Long-term portion	$ 6,590	$ 8,813

Note 5 - Intellectual Propert_2

Note 5 - Intellectual Property (Details Textual)	6 Months Ended
	Jun. 30, 2021
Developed Technology Rights [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	1 year 9 months 18 days
Technology-Based Intangible Assets [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	5 years 9 months 18 days

Note 5 - Intellectual Propert_3

Note 5 - Intellectual Property - Intellectual Property (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Finite-Lived Intangible Assets, Gross	$ 69,238	$ 69,238
Finite-Lived Intangible Assets, Accumulated Amortization	(55,940)	(51,902)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	2,645	4,931
Intellectual property, net	15,943	22,267
Developed Technology Rights [Member]
Finite-Lived Intangible Assets, Gross	68,838	68,838
Finite-Lived Intangible Assets, Accumulated Amortization	(55,755)	(51,734)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	2,601	4,872
Intellectual property, net	15,684	21,976
Technology-Based Intangible Assets [Member]
Finite-Lived Intangible Assets, Gross	400	400
Finite-Lived Intangible Assets, Accumulated Amortization	(185)	(168)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	44	59
Intellectual property, net	$ 259	$ 291

Note 6 - Income Taxes (Details

Note 6 - Income Taxes (Details Textual) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2021
Effective Income Tax Rate Reconciliation, Percent, Total	0.00%	4.80%	0.10%	4.40%
Deferred Income Tax Expense (Benefit), Total	$ 0	$ 700	$ 0	$ 1,400
Current Income Tax Expense (Benefit), Total	0	$ 10	(40)	$ 30
Unrecognized Tax Benefits that Would Impact Effective Tax Rate	$ 0		$ 0
Forecast [Member]
Effective Income Tax Rate Reconciliation, Percent, Total					(0.10%)

Note 7 - Notes Payable - Payr_2

Note 7 - Notes Payable - Payroll Protection Program (Details Textual) - USD ($)	Jun. 10, 2021	Apr. 27, 2020	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Gain (Loss) on Extinguishment of Debt, Total			$ 2,847,000	$ 0	$ 2,847,000	$ 0
Paycheck Protection Program CARES Act [Member]
Proceeds from Issuance of Long-term Debt, Total		$ 2,815,200
Debt Instrument, Term (Year)		2 years
Debt Instrument, Interest Rate, Stated Percentage		1.00%
Debt Instrument, Decrease, Forgiveness	$ 2,800,000
Gain (Loss) on Extinguishment of Debt, Total			$ 2,800,000		$ 2,800,000

Note 8 - Equity Offerings (Deta

Note 8 - Equity Offerings (Details Textual) - USD ($)	Jan. 29, 2021	Jan. 12, 2021	Jul. 06, 2020	Mar. 10, 2020	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020	Dec. 31, 2019	May 19, 2021	Oct. 09, 2020	Aug. 12, 2019	Apr. 28, 2017
Proceeds from Issuance of Equity Net										$ 0	$ 13,525,000
Shares Issued, Price Per Share (in dollars per share)																	$ 1
Preferred Stock, Par or Stated Value Per Share (in dollars per share)					$ 0.01					$ 0.01		$ 0.01
Preferred Stock Dividends, Income Statement Impact					$ 0		$ 0			$ 0	412,000	$ 400,000
Convertible Preferred Stock Converted to Other Securities							$ 299,000			0	299,000	$ 300,000
Proceeds from Warrant Exercises										30,600,000
Stock Issued During Period, Value, New Issues					$ 992,000	$ 129,322,000		$ 11,212,000
Proceeds from Issuance of Common Stock, Net										$ 130,314,000	$ 11,212,000
Stock Issued During Period, Shares, Warrants Exercised (in shares)										45,314,101
Preferred Stock [Member]
Stock Issued During Period, Shares, New Issues (in shares)					0	0		0
Stock Issued During Period, Shares, Conversion of Convertible Securities (in shares)							(4,884,000)	(3,053,000)	(7,900,000)
Stock Issued During Period Shares Stock Options and Warrants Exercised (in shares)					0	0	0
Stock Issued During Period, Value, New Issues					$ 0	$ 0		$ 0
Common Stock [Member]
Stock Issued During Period, Shares, New Issues (in shares)					332,000	70,666,000		7,030,000
Stock Issued During Period, Shares, Conversion of Convertible Securities (in shares)							4,884,000	3,053,000
Stock Issued During Period Shares Stock Options and Warrants Exercised (in shares)					508,000	45,114,000	4,913,000					4,900,000
Stock Issued During Period, Value, New Issues					$ 0	$ 71,000		$ 7,000
Series C Warrants [Member]
Proceeds from Warrant Exercises												$ 3,300,000
Series B Warrant [Member]
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share)					$ 0.35					$ 0.35		$ 0.35					$ 13
Class of Warrant or Right, Outstanding (in shares)					567,660					567,660
Series A Preferred Stock [Member]
Preferred Stock, Par or Stated Value Per Share (in dollars per share)				$ 0.01
The 2019 ATM Offering [Member]
Stock Offering Agreement, Maximum Share Value																$ 25,000,000
Stock Offering Agreement, Commission, Percent																3.00%
Proceeds from Issuance or Sale of Equity, Total												$ 11,600,000	$ 7,200,000
Proceeds from Issuance of Equity Net												$ 11,200,000	$ 7,000,000
The 2020 ATM Offering [Member]
Stock Offering Agreement, Maximum Share Value															$ 40,000,000
Stock Offering Agreement, Commission, Percent															3.00%
The 2021 ATM Offering [Member]
Stock Offering Agreement, Maximum Share Value														$ 100,000,000
Stock Offering Agreement, Commission, Percent														3.00%
Proceeds from Issuance or Sale of Equity, Total										$ 1,152,000
Proceeds from Issuance of Equity Net										$ 1,118,000
Stock Issued During Period, Shares, New Issues (in shares)										331,811
Shares Issued, Price Per Share (in dollars per share)					$ 3.47					$ 3.47
Public Offering [Member]
Proceeds from Issuance of Equity Net			$ 13,600,000	$ 13,500,000
Stock Issued During Period, Shares, New Issues (in shares)	26,545,832		42,857,142
Shares Issued, Price Per Share (in dollars per share)	$ 3		$ 0.35
Stock Issued During Period, Value, New Issues								$ 13,525,000
Proceeds from Issuance of Common Stock	$ 79,600,000					73,400,000
Proceeds from Issuance of Common Stock, Net	$ 73,400,000
Public Offering [Member] | Preferred Stock [Member]
Stock Issued During Period, Shares, New Issues (in shares)								7,937,000
Stock Issued During Period, Value, New Issues								$ 79,000
Public Offering [Member] | Common Stock [Member]
Stock Issued During Period, Shares, New Issues (in shares)								14,122,000
Stock Issued During Period, Value, New Issues								$ 14,000
Public Offering [Member] | Series C Warrants [Member]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights (in shares)				3,308,823
Public Offering [Member] | Series D Warrants [Member]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights (in shares)				3,308,823
Public Offering [Member] | Class A Units [Member]
Stock Issued During Period, Shares, New Issues (in shares)				14,121,766
Shares Issued, Price Per Share (in dollars per share)				$ 0.68
Public Offering [Member] | Class B Units [Member]
Stock Issued During Period, Shares, New Issues (in shares)				7,937,057
Shares Issued, Price Per Share (in dollars per share)				$ 0.68
Registered Direct Offering [Member]
Stock Issued During Period, Shares, New Issues (in shares)		25,000,000
Shares Issued, Price Per Share (in dollars per share)		$ 1.25
Stock Issued During Period, Value, New Issues		$ 31,250,000
Proceeds from Issuance of Common Stock		$ 28,600,000				$ 28,600,000

Note 8 - Equity Offerings - Sum

Note 8 - Equity Offerings - Summary of Sales Under Offering (Details) - USD ($) $ / shares in Units, $ in Thousands	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Apr. 28, 2017
Average price per share (in dollars per share)			$ 1
Net proceeds	$ 0	$ 13,525
The 2019 ATM Offering and 2020 ATM Offering [Member]
Total shares of common stock sold (in shares)	19,120,037
Average price per share (in dollars per share)	$ 1.47
Gross proceeds	$ 28,100
Commissions earned by Cantor	843
Net proceeds	$ 27,257
The 2021 ATM Offering [Member]
Total shares of common stock sold (in shares)	331,811
Average price per share (in dollars per share)	$ 3.47
Gross proceeds	$ 1,152
Commissions earned by Cantor	34
Net proceeds	$ 1,118

Note 9 - Basic and Diluted Ne_3

Note 9 - Basic and Diluted Net Loss per Share - Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	7,064,579	53,776,773
Share-based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	4,279,335	4,278,967
Warrant [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	1,016,383	46,461,630
Restricted Stock Units (RSUs) [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	1,768,861	3,036,176

Note 10 - Commitments and Con_3

Note 10 - Commitments and Contingencies (Details Textual) $ in Thousands, € in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2021USD ($)	Jun. 30, 2021EUR (€)	Jun. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Business Combination, Contingent Consideration, Liability, Total	$ 4,671		$ 4,671			$ 3,936
Operating Lease, Weighted Average Discount Rate, Percent	7.90%		7.90%			8.20%
Operating Lease, Right-of-Use Asset	$ 4,099		$ 4,099			$ 1,164
Operating Lease, Liability, Total	4,326		4,326
Operating Lease, Liability, Current	861		861			686
Operating Lease, Liability, Noncurrent	3,465		3,465			$ 628
Operating Lease, Cost	$ 400	$ 500	$ 900		$ 1,000
Operating Lease, Weighted Average Remaining Lease Term (Year)	8 years 10 months 24 days		8 years 10 months 24 days
Operating Lease, Payments	$ 100	$ 300	$ 500		$ 700
Minimum [Member]
Lessee, Operating Lease, Discount Rate	6.10%		6.10%
Maximum [Member]
Lessee, Operating Lease, Discount Rate	8.50%		8.50%
Senhance Surgical Robotic System Acquisition[Member]
Business Combination, Contingent Consideration, Liability, Total	$ 4,700		$ 4,700
Senhance Surgical Robotic System Acquisition[Member] | License and Supply Agreement [Member]
Contractual Obligation, to be Paid, Remainder of Fiscal Year	3,600		3,600
Contractual Obligation, to be Paid, Year One	100		100
Contractual Obligation, to be Paid, Year Two	300		300
Contractual Obligation, to be Paid, Year Three	200		200
Contractual Obligation, to be Paid, after Year Three	$ 200		$ 200
Senhance Surgical Robotic System Acquisition[Member] | Minimum [Member]
Business Combination Contingent Consideration Arrangements Target Revenue | €				€ 25

Note 10 - Commitments and Con_4

Note 10 - Commitments and Contingencies - Minimum Lease Payments (Details) $ in Thousands	Jun. 30, 2021USD ($)
Remainder of 2021	$ 515
2022	851
2023	585
2024	484
2025	487
Thereafter	2,932
Total minimum lease payments	5,854
Less: Amount of lease payments representing interest	(1,528)
Present value of future minimum lease payments	$ 4,326