Asensus Surgical (TRXDW) 10-Q 8 Aug 22 2022 Q2 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2022	Aug. 05, 2022
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	2022
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2022
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	Large Accelerated Filer
Entity Small Business	false
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	NYSE
Entity Common Stock, Shares Outstanding		236,718,923

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Revenue:
Revenue	$ 994	$ 1,102	$ 2,060	$ 3,185
Cost of revenue:
Cost of revenue	2,347	2,347	4,170	5,459
Gross loss	(1,353)	(1,245)	(2,110)	(2,274)
Operating Expenses:
Research and development	7,253	4,089	13,681	8,304
Sales and marketing	3,602	3,562	7,321	6,615
General and administrative	4,992	3,848	10,525	7,840
Amortization of intangible assets	2,533	2,862	5,203	5,729
Change in fair value of contingent consideration	(598)	478	(752)	735
Property and equipment impairment	432	0	432	0
Total Operating Expenses	18,214	14,839	36,410	29,223
Operating Loss	(19,567)	(16,084)	(38,520)	(31,497)
Other Income (Expense), net
Gain on extinguishment of debt	0	2,847	0	2,847
Change in fair value of warrant liabilities	0	0	0	(1,981)
Interest income	260	79	515	131
Interest expense	(141)	(5)	(341)	(12)
Other expense, net	(86)	(7)	(232)	(36)
Total Other Income (Expense), net	33	2,914	(58)	949
Loss before income taxes	(19,534)	(13,170)	(38,578)	(30,548)
Income tax (expense) benefit	(85)	(2)	(169)	36
Net loss	(19,619)	(13,172)	(38,747)	(30,512)
Comprehensive loss:
Net loss	(19,619)	(13,172)	(38,747)	(30,512)
Foreign currency translation (loss) gain	(1,713)	472	(2,363)	(1,466)
Unrealized loss on available-for-sale investments	(144)	0	(696)	0
Comprehensive loss	$ (21,476)	$ (12,700)	$ (41,806)	$ (31,978)
Net loss per common share attributable to common stockholders - basic and diluted (in dollars per share)	$ (0.08)	$ (0.06)	$ (0.16)	$ (0.14)
Weighted average number of shares used in computing net loss per common share - basic and diluted (in shares)	236,505	233,250	236,201	219,199
Product [Member]
Revenue:
Revenue	$ 254	$ 363	$ 601	$ 1,726
Cost of revenue:
Cost of revenue	883	1,003	1,259	2,678
Service [Member]
Revenue:
Revenue	424	406	732	785
Cost of revenue:
Cost of revenue	646	636	1,141	1,002
Lease [Member]
Revenue:
Revenue	316	333	727	674
Cost of revenue:
Cost of revenue	$ 818	$ 708	$ 1,770	$ 1,779

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Current Assets:
Cash and cash equivalents	$ 10,844	$ 18,129
Short-term investments, available-for-sale	83,360	80,262
Accounts receivable, net	699	749
Inventories	8,451	8,634
Prepaid expenses	2,927	3,255
Employee retention tax credit receivable	1,147	1,311
Other current assets	1,134	957
Total Current Assets	108,562	113,297
Restricted cash	1,290	1,154
Long-term investments, available-for-sale	9,581	37,435
Inventories, net of current portion	7,258	7,074
Property and equipment, net	9,389	10,971
Intellectual property, net	4,122	9,892
Net deferred tax assets	244	288
Operating lease right-of-use assets, net	4,747	5,348
Other long-term assets	2,157	1,014
Total Assets	147,350	186,473
Current Liabilities:
Accounts payable	3,849	3,448
Accrued employee compensation and benefits	3,127	3,559
Accrued expenses and other current liabilities	1,617	1,617
Operating lease liabilities - current portion	579	683
Deferred revenue	510	543
Total Current Liabilities	9,682	9,850
Long-Term Liabilities:
Contingent consideration	1,619	2,371
Noncurrent operating lease liabilities	4,610	5,006
Total Liabilities	15,911	17,227
Commitments and Contingencies (Note 14)
Stockholders' Equity:
Common stock $0.001 par value, 750,000,000 shares authorized at June 30, 2022 and December 31, 2021; 236,620,415 and 235,218,552 shares issued and outstanding at June 30, 2022 and December 31, 2021, respectively	237	235
Preferred stock, $0.01 par value, 25,000,000 shares authorized, no shares issued and outstanding at June 30, 2022 and December 31, 2021	0	0
Additional paid-in capital	958,646	954,649
Accumulated deficit	(824,121)	(785,374)
Accumulated other comprehensive loss	(3,323)	(264)
Total Stockholders' Equity	131,439	169,246
Total Liabilities and Stockholders' Equity	147,350	186,473
Intellectual Property [Member]
Current Assets:
Intellectual property, net	$ 4,122	$ 9,892

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares	Jun. 30, 2022	Dec. 31, 2021
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)	236,620,415	235,218,552
Common stock, shares outstanding (in shares)	236,620,415	235,218,552
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 ($) $ in Thousands	Common 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, 2020	116,231,000	0
Balance at Dec. 31, 2020	$ 116	$ 0	$ 781,397	$ (722,912)	$ 2,968	$ 61,569
Stock-based compensation	$ 0	$ 0	1,786	0	0	1,786
Award of restricted stock units (in shares)	706,000	0
Award of restricted stock units	$ 1	$ 0	0	0	0	1
Return of common stock to pay withholding taxes on restricted stock (in shares)	0	67,000
Return of common stock to pay withholding taxes on restricted stock	$ 0	$ 0	(214)	0	0	(214)
Cancellation of treasury stock (in shares)	0	(67,000)
Cancellation of treasury stock	$ 0	$ 0	0	0	0	0
Other comprehensive loss	0	0	0	0	(1,938)	(1,938)
Net loss	$ 0	$ 0	0	(17,340)	0	(17,340)
Issuance of common stock, net of issuance costs (in shares)	70,666,000	0
Issuance of common stock, net of issuance costs	$ 71	$ 0	129,251	0	0	129,322
Exercise of stock options and warrants (in shares)	45,114,000	0
Exercise of stock options and warrants	$ 45	$ 0	32,687	0	0	32,732
Balance (in shares) at Mar. 31, 2021	232,717,000	0
Balance at Mar. 31, 2021	$ 233	$ 0	944,907	(740,252)	1,030	205,918
Balance (in shares) at Dec. 31, 2020	116,231,000	0
Balance at Dec. 31, 2020	$ 116	$ 0	781,397	(722,912)	2,968	61,569
Net loss						(30,512)
Balance (in shares) at Jun. 30, 2021	234,231,000	0
Balance at Jun. 30, 2021	$ 234	$ 0	947,249	(753,424)	1,502	195,561
Balance (in shares) at Mar. 31, 2021	232,717,000	0
Balance at Mar. 31, 2021	$ 233	$ 0	944,907	(740,252)	1,030	205,918
Stock-based compensation	$ 0	$ 0	1,842	0	0	1,842
Award of restricted stock units (in shares)	674,000	0
Award of restricted stock units	$ 1	$ 0	0	0	0	1
Return of common stock to pay withholding taxes on restricted stock (in shares)	0	246,000
Return of common stock to pay withholding taxes on restricted stock	$ 0	$ 0	(829)	0	0	(829)
Cancellation of treasury stock (in shares)	0	(246,000)
Cancellation of treasury stock	$ 0	$ 0	0	0	0	0
Other comprehensive loss	0	0	0	0	472	472
Net loss	$ 0	$ 0	0	(13,172)	0	(13,172)
Issuance of common stock, net of issuance costs (in shares)	332,000	0
Issuance of common stock, net of issuance costs	$ 0	$ 0	992	0	0	992
Exercise of stock options and warrants (in shares)	508,000	0
Exercise of stock options and warrants	$ 0	$ 0	337	0	0	337
Balance (in shares) at Jun. 30, 2021	234,231,000	0
Balance at Jun. 30, 2021	$ 234	$ 0	947,249	(753,424)	1,502	195,561
Balance (in shares) at Dec. 31, 2021	235,219,000	0
Balance at Dec. 31, 2021	$ 235	$ 0	954,649	(785,374)	(264)	169,246
Stock-based compensation	$ 0		2,245	0	0	2,245
Exercise of stock options (in shares)	30,000	0
Exercise of stock options	$ 0	$ 0	12	0	0	12
Award of restricted stock units (in shares)	1,166,000	0
Award of restricted stock units	$ 1	$ 0	0	0	0	1
Return of common stock to pay withholding taxes on restricted stock (in shares)	0	436,000
Return of common stock to pay withholding taxes on restricted stock	$ 0	$ 0	(349)	0	0	(349)
Cancellation of treasury stock (in shares)	0	(436,000)
Cancellation of treasury stock	$ 0	$ 0	0	0	0	0
Other comprehensive loss	0	0	0	0	(1,202)	(1,202)
Net loss	$ 0	$ 0		(19,128)	0	(19,128)
Balance (in shares) at Mar. 31, 2022	236,415,000	0
Balance at Mar. 31, 2022	$ 236	$ 0	956,557	(804,502)	(1,466)	150,825
Balance (in shares) at Dec. 31, 2021	235,219,000	0
Balance at Dec. 31, 2021	$ 235	$ 0	954,649	(785,374)	(264)	$ 169,246
Exercise of stock options (in shares)						43,453
Net loss						$ (38,747)
Issuance of common stock, net of issuance costs (in shares)						19,451,848
Balance (in shares) at Jun. 30, 2022	236,620,000	0
Balance at Jun. 30, 2022	$ 237	$ 0	958,646	(824,121)	(3,323)	$ 131,439
Balance (in shares) at Mar. 31, 2022	236,415,000	0
Balance at Mar. 31, 2022	$ 236	$ 0	956,557	(804,502)	(1,466)	150,825
Stock-based compensation	$ 0		2,083	0	0	2,083
Exercise of stock options (in shares)	13,000	0
Exercise of stock options	$ 0	$ 0	6	0	0	6
Award of restricted stock units (in shares)	192,000	0
Award of restricted stock units	$ 1	$ 0	0	0	0	1
Other comprehensive loss	0			0	(1,857)	(1,857)
Net loss	$ 0			(19,619)	0	(19,619)
Balance (in shares) at Jun. 30, 2022	236,620,000	0
Balance at Jun. 30, 2022	$ 237	$ 0	$ 958,646	$ (824,121)	$ (3,323)	$ 131,439

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Operating Activities:
Net loss	$ (38,747)	$ (30,512)
Adjustments to reconcile net loss to net cash and cash equivalents used in operating activities:
Depreciation	1,720	1,585
Amortization of intangible assets	5,203	5,729
Amortization of discounts and premiums on investments, net	444	0
Stock-based compensation	4,328	3,628
Gain on extinguishment of debt	0	(2,847)
Deferred tax expense (benefit)	169	(36)
Bad debt expense	9	0
Change in inventory reserves	(567)	288
Property and equipment impairment	432	0
Loss on disposal of property and equipment	97	0
Change in fair value of warrant liabilities	0	1,981
Change in fair value of contingent consideration	(752)	735
Changes in operating assets and liabilities:
Accounts receivable	(8)	127
Inventories	(1,933)	(1,687)
Operating lease right-of-use assets	409	(2,970)
Prepaid expenses	189	517
Other current and long-term assets	(1,169)	2,660
Accounts payable	524	679
Accrued expenses	(284)	(1,428)
Deferred revenue	(4)	14
Operating lease liabilities	(290)	3,052
Net cash and cash equivalents used in operating activities	(30,230)	(18,485)
Investing Activities:
Purchase of available-for-sale investments	(17,792)	0
Proceeds from maturities of available-for-sale investments	41,408	0
Purchase of property and equipment	(443)	(700)
Net cash and cash equivalents provided by (used in) investing activities	23,173	(700)
Financing Activities:
Proceeds from issuance of common stock, net of issuance costs	0	130,314
Taxes paid related to net share settlement of vesting of restricted stock units	(349)	(1,041)
Proceeds from exercise of stock options and warrants	18	30,835
Net cash and cash equivalents (used in) provided by financing activities	(331)	160,108
Effect of exchange rate changes on cash and cash equivalents	239	(329)
Net (decrease) increase in cash, cash equivalents and restricted cash	(7,149)	140,594
Cash, cash equivalents and restricted cash, beginning of period	19,283	17,529
Cash, cash equivalents and restricted cash, end of period	12,134	158,123
Supplemental Disclosure for Cash Flow Information
Cash paid for leases	549	539
Cash paid for taxes	65	50
Supplemental Schedule of Non-cash Investing and Financing Activities:
Transfer of inventories to property and equipment	724	1,243
Acquisition of property and equipment in accounts payable	0	67
Reclass of warrant liability to common stock and additional paid-in-capital	0	2,236
Lease liabilities arising from obtaining right-of-use assets	$ 0	$ 3,461

Note 1 - Description of the Bus

Note 1 - Description of the Business	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Organization, Consolidation, Basis of Presentation, Business Description and Accounting Policies [Text Block]	1. Description of the Business 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 3mm 5mm

Note 2 - Summary of Significant

Note 2 - Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2022
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. All inter-company accounts and transactions have been eliminated in consolidation. The results reported in these unaudited interim condensed consolidated financial statements should not may 2021 10 Principles of Consolidation The accompanying condensed consolidated financial statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., 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. 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: 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-lived assets, fair value estimates related to contingent consideration, stock compensation expense, revenue recognition, accounts receivable reserves, short-term and long-term investments, excess and obsolete inventory reserves, inventory classification between current and non-current, measurement of lease liabilities and corresponding right-of-use (“ROU”) assets, and deferred tax asset valuation allowances. Significant Accounting Policies There have been no 10 December 31, 2021. Reclassifications Certain amounts reported previously have been reclassified to conform to current year presentation, with no three six June 30, 2021. Impact of Recently Issued Accounting Standards In June 2016, 2016 13, Financial Instruments-Credit Losses 326 2016 13 January 1, 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 2020 06 January 1, 2022. not The Company has evaluated all other issued and ASUs not not

Note 3 - Revenue Recognition

Note 3 - Revenue Recognition	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Revenue from Contract with Customer [Text Block]	3. Revenue Recognition The following table presents revenue disaggregated by type and geography: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 (in thousands) (in thousands) U.S. Systems $ - $ - $ - $ 3 Instruments and accessories 18 79 82 141 Services 75 104 149 202 Leases 51 91 164 181 Total U.S. revenue 144 274 395 527 Outside of U.S. ("OUS") Systems - - - 921 Instruments and accessories 236 284 519 661 Services 349 302 583 583 Leases 265 242 563 493 Total OUS revenue 850 828 1,665 2,658 Total Systems - - - 924 Instruments and accessories 254 363 601 802 Services 424 406 732 785 Leases 316 333 727 674 Total revenue $ 994 $ 1,102 $ 2,060 $ 3,185 Remaining Performance Obligations Transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which the revenue has not June 30, 2022 one four Contract Assets and Liabilities 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. Deferred revenue for the periods presented was primarily related to service obligations, for which the service fees are billed up-front, generally annually. The associated deferred revenue is generally recognized ratably over the service period. The Company did not three June 30, 2022 2021 six June 30, 2022 2021 The following information summarizes the Company’s contract assets and liabilities: As of June 30, 2022 December 31, 2021 (in thousands) Contract Assets $ 57 $ 91 Deferred Revenue $ 510 $ 543 Senhance System Leasing The Company enters into operating 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 option 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. For the three six June 30, 2022, 2021, not Trade Accounts Receivable The allowance for doubtful accounts is based on the Company’s assessment of collectability of customer accounts. The Company regularly reviews the allowance by considering factors such as historical experience, credit quality, the age of the accounts receivable balances, and current economic conditions that may June 30, 2022, December 31, 2021, three six June 30, 2022, 2021, not

Note 4 - Fair Value

Note 4 - Fair Value	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Fair Value Disclosures [Text Block]	4. Fair Value The following are categories of assets and liabilities measured at fair value on a recurring basis using quoted prices in active markets for identical assets (Level 1 2 3 June 30, 2022 (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 (1) $ 10,844 $ - $ - $ 10,844 Restricted cash 1,290 - - 1,290 Short-term investments - 83,360 - 83,360 Long-term investments - 9,581 - 9,581 Total assets measured at fair value $ 12,134 $ 92,941 $ - $ 105,075 Liabilities measured at fair value Contingent consideration $ - $ - $ 1,619 $ 1,619 Total liabilities measured at fair value $ - $ - $ 1,619 $ 1,619 ( 1 90 December 31, 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 (1) $ 18,129 $ - $ - $ 18,129 Restricted cash 1,154 - - 1,154 Short-term investments - 80,262 - 80,262 Long-term investments - 37,435 - 37,435 Total assets measured at fair value $ 19,283 $ 117,697 $ - $ 136,980 Liabilities measured at fair value Contingent consideration $ - $ - $ 2,371 $ 2,371 Total liabilities measured at fair value $ - $ - $ 2,371 $ 2,371 ( 1 90 The carrying values of accounts receivable, other current assets, accounts payable, and accrued expenses and other current liabilities as of June 30, 2022, December 31, 2021, The Company’s financial liabilities consisted of contingent consideration payable to an assignee of Sofar, S.p.A., the seller, related to the Company’s 2015 The following table presents quantitative information about the inputs and valuation methodologies used for the Company’s fair value measurements for contingent consideration utilizing a Monte-Carlo simulation as of June 30, 2022 December 31, 2021: Valuation Methodology Significant Unobservable Input June 30, 2022 December 31, 2021 Contingent consideration Probability weighted income approach Milestone dates 2031 2031 Discount rate 14.5 % 9.5 % Revenue volatility 40.0 % 39.0 % EUR-to-USD exchange rate 1.05 1.14 The following table summarizes the change in fair value, as determined by Level 3 six June 30, 2022 2021: Fair Value Measurement at Reporting Date (Level 3) (in thousands) Series B Warrants Contingent consideration Balance at December 31, 2021 $ - $ 2,371 Change in fair value - (752 ) Balance at June 30, 2022 $ - $ 1,619 Balance at December 31, 2020 $ 255 $ 3,936 Exercise of warrants (2,236 ) - Change in fair value 1,981 257 Balance at June 30, 2021 $ - $ 4,193 Current portion $ - $ - Long-term portion - 1,619 Balance at June 30, 2022 $ - $ 1,619

Note 5 - Investments, Available

Note 5 - Investments, Available-for-sale	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]	5. Investments, available-for-sale The aggregate fair values of investment securities along with unrealized gains and losses determined on an individual investment security basis and included in other comprehensive loss are as follows: June 30, 2022 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commercial Paper $ 35,643 $ - $ (191 ) $ 35,452 $ 35,452 $ - Corporate Bonds 58,242 - (753 ) 57,489 47,908 9,581 Total Investments $ 93,885 $ - $ (944 ) $ 92,941 $ 83,360 $ 9,581 December 31, 2021 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commercial Paper $ 50,705 $ - $ (46 ) $ 50,659 $ 50,660 $ - Corporate Bonds 67,239 1 (202 ) 67,038 29,602 37,435 Total Investments $ 117,944 $ 1 $ (248 ) $ 117,697 $ 80,262 $ 37,435 The following table summarizes the contractual maturities of the Company’s available-for-sale investments: June 30, 2022 (in thousands) Amortized Cost Fair Value Mature in less than one year $ 84,173 $ 83,360 Mature in one to two years 9,712 9,581 Total $ 93,885 $ 92,941 Actual maturities may no six June 30, 2022, 2021,

Note 6 - Inventories

Note 6 - Inventories	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Inventory Disclosure [Text Block]	6. Inventories The components of inventories are as follows: June 30, 2022 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 14,687 $ (2,931 ) $ 11,756 Raw materials 6,137 (2,184 ) 3,953 Total inventories $ 20,824 $ (5,115 ) $ 15,709 Current Portion $ 10,113 $ (1,662 ) $ 8,451 Long-term portion 10,711 (3,453 ) 7,258 Total inventories $ 20,824 $ (5,115 ) $ 15,709 December 31, 2021 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 13,066 $ (2,987 ) $ 10,079 Raw materials 8,324 (2,695 ) 5,629 Total inventories $ 21,390 $ (5,682 ) $ 15,708 Current Portion $ 9,931 $ (1,297 ) $ 8,634 Long-term portion 11,459 (4,385 ) 7,074 Total inventories $ 21,390 $ (5,682 ) $ 15,708 The Company has determined that its December 31, 2021 March 31, 2022 no no

Note 7 - Intellectual Property

Note 7 - Intellectual Property	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Intangible Assets Disclosure [Text Block]	7. Intellectual Property The components of gross intellectual property, accumulated amortization, and net intellectual property are as follows: June 30, 2022 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (64,094 ) $ (812 ) $ 3,932 Technology and patents purchased 400 (220 ) 10 190 Total intellectual property $ 69,238 $ (64,314 ) $ (802 ) $ 4,122 December 31, 2021 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (58,912 ) $ (262 ) $ 9,664 Technology and patents purchased 400 (199 ) 27 228 Total intellectual property $ 69,238 $ (59,111 ) $ (235 ) $ 9,892 The weighted average remaining useful life of the developed technology and technology and patents purchased was 2.0 years and 4.8 years, respectively, as of June 30, 2022.

Note 8 - Leases

Note 8 - Leases	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Lessee, Operating Leases [Text Block]	8. Leases Lessee Information The Company determines if an arrangement contains a lease or service contract at inception. Where an arrangement contains a lease, the Company determines if it is an operating lease or a finance lease. Subsequently, if the arrangement is modified, the Company reevaluates the classification. The Company has entered into operating leases for corporate office buildings, vehicles, and machinery and equipment. Some of the lease agreements have renewal options, tenant improvement allowances, rent escalation clauses, and assignment and subletting clauses. While the operating leases range from one ten one six one Components of operating lease expense are primarily recorded in general and administrative on the condensed consolidated statements of operations and comprehensive loss were as follows: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 (in thousands) (in thousands) Long-term Operating $ 386 $ 485 $ 785 $ 923 Short-term Operating - - - - Total Operating lease expense $ 386 $ 485 $ 785 $ 923 Supplemental balance sheet information related to operating leases was as follows: June 30, 2022 December 31, 2021 Weighted-average remaining lease term (in years) 7.4 7.8 Weighted-average discount rate 7.4% 7.8% Incremental borrowing rate 6.1% - 8.5% 6.1% - 8.5 Maturities of operating lease obligations as of June 30, 2022 Fiscal Year 2022 $ 430 2023 972 2024 886 2025 881 2026 822 Thereafter 2,958 Total minimum lease payments $ 6,949 Less: Amount of lease payments representing interest (1,760 ) Present value of future minimum lease payments $ 5,189

Note 9 - Property and Equipment

Note 9 - Property and Equipment Impairment	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	9. Property and Equipment Impairment During the three six June 30, 2022, not

Note 10 - Income Taxes

Note 10 - Income Taxes	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Income Tax Disclosure [Text Block]	10. Income Taxes Income taxes have been accounted for using the asset and liability method in accordance with ASC 740 December 31, 2022. not three June 30, 2022 2021 six June 30, 2022 2021 The Company incurred losses for the three six June 30, 2022, December 31, 2022. not The total tax (expense) benefit during the three June 30, 2022 2021, six June 30, 2022 2021, At June 30, 2022 The FASB Staff Q&A, Topic 740, No. 5, not 2022; no six June 30, 2022 2021.

Note 11 - Stock-based Compensat

Note 11 - Stock-based Compensation	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Share-Based Payment Arrangement [Text Block]	11. Stock-Based Compensation Stock Options The following table summarizes the Company’s stock option activity, including grants to non-employees, for the six June 30, 2022: Number of Shares Weighted- Average Exercise Price Weighted-Average Remaining Contractual Term (Years) Balance at December 31, 2021 4,640,660 $ 6.64 5.66 Granted 2,555,396 0.77 Forfeited (23,047 ) 3.22 Cancelled (16,983 ) 33.27 Exercised (43,453 ) 0.41 Balance at June 30, 2022 7,112,573 $ 4.52 5.71 The following table summarizes information about stock options outstanding at June 30, 2022: Number of Shares Weighted- Average Exercise Price Weighted-Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (Millions) Exercisable at June 30, 2022 3,119,355 $ 8.02 5.08 $ - Vested or expected to vest at June 30, 2022 6,777,170 $ 4.67 5.67 $ - Restricted Stock Units The following is a summary of the restricted stock units activity, including performance restricted stock units, for the six June 30, 2022: Number of Restricted Stock Units Outstanding Weighted- Average Grant Date Fair Value Unvested December 31, 2021 3,839,030 $ 2.36 Granted 6,040,915 0.75 Vested (1,794,623 ) 2.47 Forfeited (100,047 ) 1.36 Unvested Jun 30, 2022 7,985,275 $ 1.13 Performance Restricted Stock Units In 2022 2021, October 1, 2023 October 1, 2022, 2022 2021 Stock-based Compensation Expense The following table summarizes non-cash stock-based compensation expense by award type for the three six June 30, 2022, 2021: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 (in thousands) (in thousands) Stock options $ 924 $ 1,087 $ 1,901 $ 2,207 Restricted stock units 822 690 1,707 1,293 Performance restricted stock units 337 33 720 70 $ 2,083 $ 1,810 $ 4,328 $ 3,570 As of June 30, 2022, June 30, 2022, The fair value of options granted were estimated using the Black-Scholes-Merton option pricing model based on the assumptions in the table below: Six Months Ended June 30, 2022 2021 Expected dividend yield 0% 0% Expected volatility 128% - 133% 118% - 136% Risk-free interest rate 1.25% - 2.98% 0.33% - 0.58% Expected life (in years) 4.3 - 4.5 3.8 - 4.5

Note 12 - Equity Offerings

Note 12 - Equity Offerings	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Stockholders' Equity Note Disclosure [Text Block]	12. Equity Offerings Equity financing transactions for the six June 30, 2021, 2020 October 9, 2020, “2020 January 2021. January 2021 January 29, 2021, February 1, 2021, January 2021 January 12, 2021, 2021 May 19, 2021, “2021 May 19, 2021, “2021 3.0% Sales during the six June 30, 2021, 2021 2020 Six Months Ended June 30, 2021 2021 ATM 2020 ATM Total Total shares of common stock sold 331,811 19,120,037 19,451,848 Average price per share $ 3.47 $ 1.47 $ 1.50 Gross proceeds $ 1,152 $ 28,100 $ 29,252 Commission earned by Sales Agents $ 34 $ 843 $ 877 Net proceeds $ 1,118 $ 27,257 $ 28,375 2021 six June 30, 2021, 2022 March 18, 2022, “2022 “2022 2022 six June 30, 2022.

Note 13 - Basic and Diluted Net

Note 13 - Basic and Diluted Net Loss Per Share	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Earnings Per Share [Text Block]	13. 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, and warrants. No three six June 30, 2022 2021 Potential common shares not June 30, 2022 2021 Stock options 7,112,573 4,279,335 Stock warrants 1,120,300 1,016,383 Nonvested restricted stock units 7,985,275 1,768,861 Total 16,218,148 7,064,579

Note 14 - Commitments and Conti

Note 14 - Commitments and Contingencies	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	14. Commitments and Contingencies License and Supply Agreements As part of the Company’s acquisition of the Senhance System in 2015, Fiscal Year 2022 $ 8,465 2023 852 2024 550 2025 339 2026 - Thereafter - Total commitments $ 10,206

Note 15 - Segments and Geograph

Note 15 - Segments and Geographic Areas	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Segment Reporting Disclosure [Text Block]	15. Segments and Geographic Areas 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 The following table presents consolidated assets and long-lived assets by geographic area, which includes property and equipment, intellectual property, and operating lease assets: June 30, 2022 Long-Lived Assets Total Assets U.S. 33 % 77 % EMEA Switzerland 40 % 18 % Italy 20 % 3 % Other 7 % 1 % Total EMEA 67 % 22 % Asia 0 % 1 % Total 100 % 100 % December 31, 2021 Long-Lived Assets Total Assets U.S. 26 % 77 % EMEA Switzerland 34 % 16 % Italy 36 % 5 % Other 4 % 1 % Total EMEA 74 % 22 % Asia 0 % 1 % Total 100 % 100 % The Company recognizes sales by geographic area based on the country in which the customer is based. For the three June 30, 2022 2021, six June 30, 2022 2021,

Note 16 - Related Person Transa

Note 16 - Related Person Transactions	6 Months Ended
	Jun. 30, 2022
Notes to Financial Statements
Related Party Transactions Disclosure [Text Block]	16. Related Person Transactions In March 2018, 1 1 three June 30, 2022 2021, six June 30, 2022 2021,

Significant Accounting Policies

Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2022
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. All inter-company accounts and transactions have been eliminated in consolidation. The results reported in these unaudited interim condensed consolidated financial statements should not may 2021 10
Consolidation, Policy [Policy Text Block]	Principles of Consolidation The accompanying condensed consolidated financial statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., 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.
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: 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-lived assets, fair value estimates related to contingent consideration, stock compensation expense, revenue recognition, accounts receivable reserves, short-term and long-term investments, excess and obsolete inventory reserves, inventory classification between current and non-current, measurement of lease liabilities and corresponding right-of-use (“ROU”) assets, and deferred tax asset valuation allowances.
Significant Accounting Policies [Policy Text Block]	Significant Accounting Policies There have been no 10 December 31, 2021.
Reclassification, Comparability Adjustment [Policy Text Block]	Reclassifications Certain amounts reported previously have been reclassified to conform to current year presentation, with no three six June 30, 2021.
New Accounting Pronouncements, Policy [Policy Text Block]	Impact of Recently Issued Accounting Standards In June 2016, 2016 13, Financial Instruments-Credit Losses 326 2016 13 January 1, 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 2020 06 January 1, 2022. not The Company has evaluated all other issued and ASUs not not

Note 3 - Revenue Recognition (T

Note 3 - Revenue Recognition (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Disaggregation of Revenue [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 (in thousands) (in thousands) U.S. Systems $ - $ - $ - $ 3 Instruments and accessories 18 79 82 141 Services 75 104 149 202 Leases 51 91 164 181 Total U.S. revenue 144 274 395 527 Outside of U.S. ("OUS") Systems - - - 921 Instruments and accessories 236 284 519 661 Services 349 302 583 583 Leases 265 242 563 493 Total OUS revenue 850 828 1,665 2,658 Total Systems - - - 924 Instruments and accessories 254 363 601 802 Services 424 406 732 785 Leases 316 333 727 674 Total revenue $ 994 $ 1,102 $ 2,060 $ 3,185
Contract with Customer, Contract Asset, Contract Liability, and Receivable [Table Text Block]	As of June 30, 2022 December 31, 2021 (in thousands) Contract Assets $ 57 $ 91 Deferred Revenue $ 510 $ 543

Note 4 - Fair Value (Tables)

Note 4 - Fair Value (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Fair Value, Assets Measured on Recurring Basis [Table Text Block]	June 30, 2022 (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 (1) $ 10,844 $ - $ - $ 10,844 Restricted cash 1,290 - - 1,290 Short-term investments - 83,360 - 83,360 Long-term investments - 9,581 - 9,581 Total assets measured at fair value $ 12,134 $ 92,941 $ - $ 105,075 Liabilities measured at fair value Contingent consideration $ - $ - $ 1,619 $ 1,619 Total liabilities measured at fair value $ - $ - $ 1,619 $ 1,619 December 31, 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 (1) $ 18,129 $ - $ - $ 18,129 Restricted cash 1,154 - - 1,154 Short-term investments - 80,262 - 80,262 Long-term investments - 37,435 - 37,435 Total assets measured at fair value $ 19,283 $ 117,697 $ - $ 136,980 Liabilities measured at fair value Contingent consideration $ - $ - $ 2,371 $ 2,371 Total liabilities measured at fair value $ - $ - $ 2,371 $ 2,371
Fair Value Measurement Inputs and Valuation Techniques [Table Text Block]	Valuation Methodology Significant Unobservable Input June 30, 2022 December 31, 2021 Contingent consideration Probability weighted income approach Milestone dates 2031 2031 Discount rate 14.5 % 9.5 % Revenue volatility 40.0 % 39.0 % EUR-to-USD exchange rate 1.05 1.14
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]	Fair Value Measurement at Reporting Date (Level 3) (in thousands) Series B Warrants Contingent consideration Balance at December 31, 2021 $ - $ 2,371 Change in fair value - (752 ) Balance at June 30, 2022 $ - $ 1,619 Balance at December 31, 2020 $ 255 $ 3,936 Exercise of warrants (2,236 ) - Change in fair value 1,981 257 Balance at June 30, 2021 $ - $ 4,193 Current portion $ - $ - Long-term portion - 1,619 Balance at June 30, 2022 $ - $ 1,619

Note 5 - Investments, Availab_2

Note 5 - Investments, Available-for-sale (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Debt Securities, Available-for-Sale [Table Text Block]	June 30, 2022 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commercial Paper $ 35,643 $ - $ (191 ) $ 35,452 $ 35,452 $ - Corporate Bonds 58,242 - (753 ) 57,489 47,908 9,581 Total Investments $ 93,885 $ - $ (944 ) $ 92,941 $ 83,360 $ 9,581 December 31, 2021 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commercial Paper $ 50,705 $ - $ (46 ) $ 50,659 $ 50,660 $ - Corporate Bonds 67,239 1 (202 ) 67,038 29,602 37,435 Total Investments $ 117,944 $ 1 $ (248 ) $ 117,697 $ 80,262 $ 37,435
Investments Classified by Contractual Maturity Date [Table Text Block]	June 30, 2022 (in thousands) Amortized Cost Fair Value Mature in less than one year $ 84,173 $ 83,360 Mature in one to two years 9,712 9,581 Total $ 93,885 $ 92,941

Note 6 - Inventories (Tables)

Note 6 - Inventories (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Schedule of Inventory, Current [Table Text Block]	June 30, 2022 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 14,687 $ (2,931 ) $ 11,756 Raw materials 6,137 (2,184 ) 3,953 Total inventories $ 20,824 $ (5,115 ) $ 15,709 Current Portion $ 10,113 $ (1,662 ) $ 8,451 Long-term portion 10,711 (3,453 ) 7,258 Total inventories $ 20,824 $ (5,115 ) $ 15,709 December 31, 2021 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 13,066 $ (2,987 ) $ 10,079 Raw materials 8,324 (2,695 ) 5,629 Total inventories $ 21,390 $ (5,682 ) $ 15,708 Current Portion $ 9,931 $ (1,297 ) $ 8,634 Long-term portion 11,459 (4,385 ) 7,074 Total inventories $ 21,390 $ (5,682 ) $ 15,708

Note 7 - Intellectual Property

Note 7 - Intellectual Property (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Schedule of Finite-Lived Intangible Assets [Table Text Block]	June 30, 2022 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (64,094 ) $ (812 ) $ 3,932 Technology and patents purchased 400 (220 ) 10 190 Total intellectual property $ 69,238 $ (64,314 ) $ (802 ) $ 4,122 December 31, 2021 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (58,912 ) $ (262 ) $ 9,664 Technology and patents purchased 400 (199 ) 27 228 Total intellectual property $ 69,238 $ (59,111 ) $ (235 ) $ 9,892

Note 8 - Leases (Tables)

Note 8 - Leases (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Lease, Cost [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 (in thousands) (in thousands) Long-term Operating $ 386 $ 485 $ 785 $ 923 Short-term Operating - - - - Total Operating lease expense $ 386 $ 485 $ 785 $ 923
Lessee, Operating Lease, Disclosure [Table Text Block]	June 30, 2022 December 31, 2021 Weighted-average remaining lease term (in years) 7.4 7.8 Weighted-average discount rate 7.4% 7.8% Incremental borrowing rate 6.1% - 8.5% 6.1% - 8.5
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Fiscal Year 2022 $ 430 2023 972 2024 886 2025 881 2026 822 Thereafter 2,958 Total minimum lease payments $ 6,949 Less: Amount of lease payments representing interest (1,760 ) Present value of future minimum lease payments $ 5,189

Note 11 - Stock-based Compens_2

Note 11 - Stock-based Compensation (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Share-Based Payment Arrangement, Option, Activity [Table Text Block]	Number of Shares Weighted- Average Exercise Price Weighted-Average Remaining Contractual Term (Years) Balance at December 31, 2021 4,640,660 $ 6.64 5.66 Granted 2,555,396 0.77 Forfeited (23,047 ) 3.22 Cancelled (16,983 ) 33.27 Exercised (43,453 ) 0.41 Balance at June 30, 2022 7,112,573 $ 4.52 5.71
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Vested and Expected to Vest, Exercisable [Table Text Block]	Number of Shares Weighted- Average Exercise Price Weighted-Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (Millions) Exercisable at June 30, 2022 3,119,355 $ 8.02 5.08 $ - Vested or expected to vest at June 30, 2022 6,777,170 $ 4.67 5.67 $ -
Share-Based Payment Arrangement, Restricted Stock Unit, Activity [Table Text Block]	Number of Restricted Stock Units Outstanding Weighted- Average Grant Date Fair Value Unvested December 31, 2021 3,839,030 $ 2.36 Granted 6,040,915 0.75 Vested (1,794,623 ) 2.47 Forfeited (100,047 ) 1.36 Unvested Jun 30, 2022 7,985,275 $ 1.13
Share-Based Payment Arrangement, Cost by Plan [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 (in thousands) (in thousands) Stock options $ 924 $ 1,087 $ 1,901 $ 2,207 Restricted stock units 822 690 1,707 1,293 Performance restricted stock units 337 33 720 70 $ 2,083 $ 1,810 $ 4,328 $ 3,570
Schedule of Share-Based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	Six Months Ended June 30, 2022 2021 Expected dividend yield 0% 0% Expected volatility 128% - 133% 118% - 136% Risk-free interest rate 1.25% - 2.98% 0.33% - 0.58% Expected life (in years) 4.3 - 4.5 3.8 - 4.5

Note 12 - Equity Offerings (Tab

Note 12 - Equity Offerings (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Schedule of Sales Under Sales Agency Agreement [Table Text Block]	Six Months Ended June 30, 2021 2021 ATM 2020 ATM Total Total shares of common stock sold 331,811 19,120,037 19,451,848 Average price per share $ 3.47 $ 1.47 $ 1.50 Gross proceeds $ 1,152 $ 28,100 $ 29,252 Commission earned by Sales Agents $ 34 $ 843 $ 877 Net proceeds $ 1,118 $ 27,257 $ 28,375

Note 13 - Basic and Diluted N_2

Note 13 - Basic and Diluted Net Loss Per Share (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block]	June 30, 2022 2021 Stock options 7,112,573 4,279,335 Stock warrants 1,120,300 1,016,383 Nonvested restricted stock units 7,985,275 1,768,861 Total 16,218,148 7,064,579

Note 14 - Commitments and Con_2

Note 14 - Commitments and Contingencies (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Contractual Obligation, Fiscal Year Maturity [Table Text Block]	Fiscal Year 2022 $ 8,465 2023 852 2024 550 2025 339 2026 - Thereafter - Total commitments $ 10,206

Note 15 - Segments and Geogra_2

Note 15 - Segments and Geographic Areas (Tables)	6 Months Ended
	Jun. 30, 2022
Notes Tables
Long-Lived Assets by Geographic Areas [Table Text Block]	June 30, 2022 Long-Lived Assets Total Assets U.S. 33 % 77 % EMEA Switzerland 40 % 18 % Italy 20 % 3 % Other 7 % 1 % Total EMEA 67 % 22 % Asia 0 % 1 % Total 100 % 100 % December 31, 2021 Long-Lived Assets Total Assets U.S. 26 % 77 % EMEA Switzerland 34 % 16 % Italy 36 % 5 % Other 4 % 1 % Total EMEA 74 % 22 % Asia 0 % 1 % Total 100 % 100 %

Note 3 - Revenue Recognition 1

Note 3 - Revenue Recognition 1 (Details Textual) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Contract with Customer, Liability, Revenue Recognized	$ 0.3	$ 0.2	$ 0.5	$ 0.4
Accounts Receivable, Allowance for Credit Loss, Ending Balance	$ 1.5		$ 1.5		$ 1.7

Note 3 - Revenue Recognition 2

Note 3 - Revenue Recognition 2 (Details Textual) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-07-01 $ in Millions	Jun. 30, 2022 USD ($)
Revenue, Remaining Performance Obligation, Amount	$ 2.1
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)	4 years

Note 3 - Revenue Recognition -

Note 3 - Revenue Recognition - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Revenue	$ 994	$ 1,102	$ 2,060	$ 3,185
UNITED STATES
Revenue	144	274	395	527
Non-US [Member]
Revenue	850	828	1,665	2,658
Systems [Member]
Revenue	0	0	0	924
Systems [Member] | UNITED STATES
Revenue	0	0	0	3
Systems [Member] | Non-US [Member]
Revenue	0	0	0	921
Instruments and Accessories [Member]
Revenue	254	363	601	802
Instruments and Accessories [Member] | UNITED STATES
Revenue	18	79	82	141
Instruments and Accessories [Member] | Non-US [Member]
Revenue	236	284	519	661
Service [Member]
Revenue	424	406	732	785
Service [Member] | UNITED STATES
Revenue	75	104	149	202
Service [Member] | Non-US [Member]
Revenue	349	302	583	583
Lease [Member]
Revenue	316	333	727	674
Lease [Member] | UNITED STATES
Revenue	51	91	164	181
Lease [Member] | Non-US [Member]
Revenue	$ 265	$ 242	$ 563	$ 493

Note 3 - Revenue Recognition _2

Note 3 - Revenue Recognition - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Contract Assets	$ 57	$ 91
Deferred Revenue	$ 510	$ 543

Note 4 - Fair Value - Summary o

Note 4 - Fair Value - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands		Jun. 30, 2022	Dec. 31, 2021
Cash and cash equivalents	[1]	$ 10,844	$ 18,129
Restricted cash		1,290	1,154
Short-term investments		83,360	80,262
Long-term investments		9,581	37,435
Total assets measured at fair value		105,075	136,980
Contingent consideration		1,619	2,371
Total liabilities measured at fair value		1,619	2,371
Fair Value, Inputs, Level 1 [Member]
Cash and cash equivalents	[1]	10,844	18,129
Restricted cash		1,290	1,154
Short-term investments		0	0
Long-term investments		0	0
Total assets measured at fair value		12,134	19,283
Contingent consideration		0	0
Total liabilities measured at fair value		0	0
Fair Value, Inputs, Level 2 [Member]
Cash and cash equivalents	[1]	0	0
Restricted cash		0	0
Short-term investments		83,360	80,262
Long-term investments		9,581	37,435
Total assets measured at fair value		92,941	117,697
Contingent consideration		0	0
Total liabilities measured at fair value		0	0
Fair Value, Inputs, Level 3 [Member]
Cash and cash equivalents	[1]	0	0
Restricted cash		0	0
Short-term investments		0	0
Long-term investments		0	0
Total assets measured at fair value		0	0
Contingent consideration		1,619	2,371
Total liabilities measured at fair value		$ 1,619	$ 2,371
[1]Includes investments that are readily convertible to cash with original maturities of 90 days or less.

Note 4 - Fair Value - Quantitat

Note 4 - Fair Value - Quantitative Information about Inputs and Valuation Methodologies Used for Fair Value Measurements Classification (Details) - Senhance Surgical Robotic System Acquisition[Member] - Fair Value, Inputs, Level 3 [Member]	Jun. 30, 2022	Dec. 31, 2021
Measurement Input, Discount Rate [Member]
Contingent consideration, measurement input	0.145	0.095
Measurement Input, Price Volatility [Member]
Contingent consideration, measurement input	0.400	0.390
Measurement Input, Currency Exchange Rate [Member]
Contingent consideration, measurement input	1.05	1.14

Note 4 - Fair Value - Summary_2

Note 4 - Fair Value - Summary of Change in Fair Value for Warrants and Contingent Consideration (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Warrant [Member]
Balance	$ 0	$ 255
Change in fair value	0	1,981
Settlement		(2,236)
Balance	0	0
Current portion	0
Long-term portion	0
Balance	0	0
Contingent Consideration [Member]
Balance	2,371	3,936
Change in fair value	(752)	257
Settlement		0
Balance	1,619	4,193
Current portion	0
Long-term portion	1,619
Balance	$ 1,619	$ 4,193

Note 5 - Investments, Availab_3

Note 5 - Investments, Available-for-sale (Details Textual) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Proceeds from Sale of Debt Securities, Available-for-Sale	$ 0	$ 0

Note 5 - Investments, Availab_4

Note 5 - Investments, Available-for-sale - Summary of Investment Securities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Amortized Cost	$ 93,885	$ 117,944
Unrealized Gain	0	1
Unrealized Loss	(944)	(248)
Fair Value	92,941	117,697
Short-term investments	83,360	80,262
Long-term investments	9,581	37,435
Commercial Paper [Member]
Amortized Cost	35,643	50,705
Unrealized Gain	0	0
Unrealized Loss	(191)	(46)
Fair Value	35,452	50,659
Short-term investments	35,452	50,660
Long-term investments	0	0
Corporate Debt Securities [Member]
Amortized Cost	58,242	67,239
Unrealized Gain	0	1
Unrealized Loss	(753)	(202)
Fair Value	57,489	67,038
Short-term investments	47,908	29,602
Long-term investments	$ 9,581	$ 37,435

Note 5 - Investments, Availab_5

Note 5 - Investments, Available-for-sale - Contractual Maturities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Mature in less than one year, amortized cost	$ 84,173
Mature in less than one year, fair value	83,360
Mature in one to two years, amortized cost	9,712
Mature in one to two years, fair value	9,581
Total, amortized cost	93,885	$ 117,944
Total, fair value	$ 92,941	$ 117,697

Note 6 - Inventories (Details T

Note 6 - Inventories (Details Textual) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Overstated Raw Materials, Amount	$ 2.5	$ 2.5

Note 6 - Inventories - Componen

Note 6 - Inventories - Components of Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Finished goods, gross	$ 14,687	$ 13,066
Finished goods, reserve	(2,931)	(2,987)
Finished goods, net	11,756	10,079
Raw materials, gross	6,137	8,324
Raw materials, reserve	(2,184)	(2,695)
Raw materials, net	3,953	5,629
Total inventories, gross	20,824	21,390
Total inventories, reserve	(5,115)	(5,682)
Total inventories, net	15,709	15,708
Current Portion, gross	10,113	9,931
Current Portion, reserve	(1,662)	(1,297)
Inventories	8,451	8,634
Long-term portion, gross	10,711	11,459
Long-term portion, reserve	(3,453)	(4,385)
Inventories, net of current portion	$ 7,258	$ 7,074

Note 7 - Intellectual Propert_2

Note 7 - Intellectual Property (Details Textual) - Weighted Average [Member]	6 Months Ended
	Jun. 30, 2022
Developed Technology Rights [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	2 years
Technology-Based Intangible Assets [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	4 years 9 months 18 days

Note 7 - Intellectual Propert_3

Note 7 - Intellectual Property - Intellectual Property (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets, Gross	$ 69,238	$ 69,238
Finite-Lived Intangible Assets, Accumulated Amortization	(64,314)	(59,111)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	(802)	(235)
Intellectual property, net	4,122	9,892
Developed Technology Rights [Member]
Finite-Lived Intangible Assets, Gross	68,838	68,838
Finite-Lived Intangible Assets, Accumulated Amortization	(64,094)	(58,912)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	(812)	(262)
Intellectual property, net	3,932	9,664
Technology-Based Intangible Assets [Member]
Finite-Lived Intangible Assets, Gross	400	400
Finite-Lived Intangible Assets, Accumulated Amortization	(220)	(199)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	10	27
Intellectual property, net	$ 190	$ 228

Note 8 - Leases (Details Textua

Note 8 - Leases (Details Textual)	Jun. 30, 2022
Minimum [Member]
Lessee, Operating Lease, Term of Contract (Year)	1 year
Lessee, Operating Lease, Renewal Term (Year)	1 year
Maximum [Member]
Lessee, Operating Lease, Term of Contract (Year)	10 years
Lessee, Operating Lease, Renewal Term (Year)	6 years

Note 8 - Leases - Components of

Note 8 - Leases - Components of Operating Lease Expense (Details) - General and Administrative Expense [Member] - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Long-term Operating	$ 386	$ 485	$ 785	$ 923
Short-term Operating	0	0	0	0
Total Operating lease expense	$ 386	$ 485	$ 785	$ 923

Note 8 - Leases -Supplemental B

Note 8 - Leases -Supplemental Balance Sheet Information (Details)	Jun. 30, 2022	Dec. 31, 2021
Weighted-average remaining lease term (in years) (Year)	7 years 4 months 24 days	7 years 9 months 18 days
Weighted-average discount rate	7.40%	7.80%
Minimum [Member]
Incremental borrowing rate	6.10%	6.10%
Maximum [Member]
Incremental borrowing rate	8.50%	8.50%

Note 8 - Leases - Minimum Lease

Note 8 - Leases - Minimum Lease Payments (Details) $ in Thousands	Jun. 30, 2022 USD ($)
2022	$ 430
2023	972
2024	886
2025	881
2026	822
Thereafter	2,958
Total minimum lease payments	6,949
Less: Amount of lease payments representing interest	(1,760)
Present value of future minimum lease payments	$ 5,189

Note 9 - Property and Equipme_2

Note 9 - Property and Equipment Impairment (Details Textual) - USD ($) $ in Millions	3 Months Ended	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2022
Impairment, Long-Lived Asset, Held-for-Use, Total	$ 0.4	$ 0.4

Note 10 - Income Taxes (Details

Note 10 - Income Taxes (Details Textual) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2022
Effective Income Tax Rate Reconciliation, Percent, Total	(0.40%)	0%	(0.40%)	0.10%
Income Tax Expense (Benefit), Total	$ 85	$ 2	$ 169	$ (36)
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued, Total	$ 0		$ 0
Forecast [Member]
Effective Income Tax Rate Reconciliation, Percent, Total					(0.40%)

Note 11 - Stock-based Compens_3

Note 11 - Stock-based Compensation (Details Textual) $ in Millions	6 Months Ended
	Jun. 30, 2022 USD ($)
Share-Based Payment Arrangement, Option [Member]
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total	$ 3.6
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)	2 years
Restricted Stock Units (RSUs) [Member]
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total	$ 6
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)	1 year 9 months 18 days

Note 11 - Stock-based Compens_4

Note 11 - Stock-based Compensation - Stock Option Activity (Details) - $ / shares	6 Months Ended	12 Months Ended
	Jun. 30, 2022	Dec. 31, 2020
Options, Outstanding, Number of Shares (in shares)	4,640,660
Options, Outstanding, Weighted Average Exercise Price (in dollars per share)	$ 6.64
Options, Outstanding, Weighted Average Remaining Contractual Term (Year)	5 years 8 months 15 days	5 years 7 months 28 days
Options, Granted, Number of Shares (in shares)	2,555,396
Options, Grants in Period, Weighted Average Exercise Price (in dollars per share)	$ 0.77
Options, Forfeited, Number of Shares (in shares)	(23,047)
Options, Forfeitures in Period, Weighted Average Exercise Price (in dollars per share)	$ 3.22
Options, Cancelled, Number of Shares (in shares)	(16,983)
Options, Expirations in Period, Weighted Average Exercise Price (in dollars per share)	$ 33.27
Options, Exercised, Number of Shares (in shares)	(43,453)
Options, Exercises in Period, Weighted Average Exercise Price (in dollars per share)	$ 0.41
Options, Outstanding, Number of Shares (in shares)	7,112,573
Options, Outstanding, Weighted Average Exercise Price (in dollars per share)	$ 4.52

Note 11 - Stock-based Compens_5

Note 11 - Stock-based Compensation - Stock Options Outstanding (Details) $ / shares in Units, $ in Millions	6 Months Ended
	Jun. 30, 2022 USD ($) $ / shares shares
Options, Exercisable, Number of Shares (in shares) | shares	3,119,355
Options, Exercisable, Weighted Average Exercise Price (in dollars per share) | $ / shares (in dollars per share) | $ / shares	$ 8.02
Options, Exercisable, Weighted Average Remaining Contractual Term (Year)	5 years 29 days
Options, Exercisable, Aggregate Intrinsic Value | $	$ 0
Options, Vested and Expected to Vest, Exercisable, Number of Shares (in shares) | shares	6,777,170
Options, Vested and Expected to Vest, Exercisable, Weighted Average Exercise Price (in dollars per share) | $ / shares	$ 4.67
Options, Vested and Expected to Vest, Exercisable, Weighted Average Remaining Contractual Term (Year)	5 years 8 months 1 day
Options, Vested or Expected to Vest, Aggregate Intrinsic Value | $	$ 0

Note 11 - Stock-based Compens_6

Note 11 - Stock-based Compensation - RSU Activity (Details) - Restricted Stock Units (RSUs) [Member]	6 Months Ended
	Jun. 30, 2022 $ / shares shares
Beginning of period, Restricted stock units, Unvested (in shares) | shares	3,839,030
Beginning of period, Restricted stock units, Unvested, weighted average grant date fair value (in dollars per share) | $ / shares	$ 2.36
Restricted stock units, Granted (in shares) | shares	6,040,915
Restricted stock units, Granted, weighted average grant date fair value (in dollars per share) | $ / shares	$ 0.75
Restricted stock units, Vested (in shares) | shares	(1,794,623)
Restricted stock units, Vested, weighted average grant date fair value (in dollars per share) | $ / shares	$ 2.47
Restricted stock units, Forfeited (in shares) | shares	(100,047)
Restricted stock units, Forfeited, weighted average grant date fair value (in dollars per share) | $ / shares	$ 1.36
Beginning of period, Restricted stock units, Unvested (in shares) | shares	7,985,275
Beginning of period, Restricted stock units, Unvested, weighted average grant date fair value (in dollars per share) | $ / shares	$ 1.13

Note 11 - Stock-based Compens_7

Note 11 - Stock-based Compensation - Non-cash Share-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Share-based compensation	$ 2,083	$ 1,810	$ 4,328	$ 3,570
Share-Based Payment Arrangement, Option [Member]
Share-based compensation	924	1,087	1,901	2,207
Restricted Stock Units (RSUs) [Member]
Share-based compensation	822	690	1,707	1,293
Performance Restricted Stock Unit [Member]
Share-based compensation	$ 337	$ 33	$ 720	$ 70

Note 11 - Stock-based Compens_8

Note 11 - Stock-based Compensation - Stock Option Valuation Assumptions (Details)	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Expected dividend yield	0%	0%
Minimum [Member]
Expected volatility	128%	118%
Risk-free interest rate	1.25%	0.33%
Expected life (in years) (Year)	4 years 3 months 18 days	3 years 9 months 18 days
Maximum [Member]
Expected volatility	133%	136%
Risk-free interest rate	2.98%	0.58%
Expected life (in years) (Year)	4 years 6 months	4 years 6 months

Note 12 - Equity Offerings (Det

Note 12 - Equity Offerings (Details Textual) - USD ($) $ / shares in Units, $ in Thousands			6 Months Ended
	Jan. 29, 2021	Jan. 12, 2021	Jun. 30, 2022	Jun. 30, 2021	Mar. 18, 2022	May 19, 2021	Oct. 09, 2020
Stock Issued During Period, Shares, New Issues (in shares)			19,451,848
Shares Issued, Price Per Share (in dollars per share)			$ 1.50
Proceeds from Issuance of Common Stock, Net			$ 0	$ 130,314
Proceeds from Warrant Exercises				$ 30,600
The 2020 ATM Offering [Member]
Stock Offering Agreement, Maximum Share Value							$ 40,000
Stock Issued During Period, Shares, New Issues (in shares)			19,120,037
Shares Issued, Price Per Share (in dollars per share)			$ 1.47
Public Offering [Member]
Stock Issued During Period, Shares, New Issues (in shares)	26,545,832
Shares Issued, Price Per Share (in dollars per share)	$ 3
Proceeds from Issuance of Common Stock, Net	$ 73,400
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
Proceeds from Issuance of Common Stock, Net		$ 28,600
The 2021 ATM Offering [Member]
Stock Offering Agreement, Maximum Share Value						$ 100,000
Stock Issued During Period, Shares, New Issues (in shares)			331,811
Shares Issued, Price Per Share (in dollars per share)			$ 3.47
The 2022 ATM Offering [Member]
Stock Offering Agreement, Maximum Share Value					$ 100,000
Stock Issued During Period, Shares, New Issues (in shares)			0

Note 12 - Equity Offerings - Su

Note 12 - Equity Offerings - Summary of Sales Under Offering (Details) $ / shares in Units, $ in Thousands	6 Months Ended
	Jun. 30, 2022 USD ($) $ / shares shares
Total shares of common stock sold (in shares) | shares	19,451,848
Average price per share (in dollars per share) | $ / shares	$ 1.50
Gross proceeds	$ 29,252
Commission earned by Sales Agents	877
Net proceeds	$ 28,375
The 2021 ATM Offering [Member]
Total shares of common stock sold (in shares) | shares	331,811
Average price per share (in dollars per share) | $ / shares	$ 3.47
Gross proceeds	$ 1,152
Commission earned by Sales Agents	34
Net proceeds	$ 1,118
The 2020 ATM Offering [Member]
Total shares of common stock sold (in shares) | shares	19,120,037
Average price per share (in dollars per share) | $ / shares	$ 1.47
Gross proceeds	$ 28,100
Commission earned by Sales Agents	843
Net proceeds	$ 27,257

Note 13 - Basic and Diluted N_3

Note 13 - Basic and Diluted Net Loss Per Share - Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	16,218,148	7,064,579
Share-Based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	7,112,573	4,279,335
Warrant [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	1,120,300	1,016,383
Restricted Stock Units (RSUs) [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	7,985,275	1,768,861

Note 14 - Commitments and Con_3

Note 14 - Commitments and Contingencies - Purchase Orders Commitments (Details) - License and Supply Agreement [Member] - Senhance Surgical Robotic System Acquisition[Member] $ in Thousands	Jun. 30, 2022 USD ($)
2022	$ 8,465
2023	852
2024	550
2025	339
2026	0
Thereafter	0
Total commitments	$ 10,206

Note 15 - Segments and Geogra_3

Note 15 - Segments and Geographic Areas (Details Textual)	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Number of Operating Segments			1
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | UNITED STATES
Concentration Risk, Percentage	15%	25%	19%	17%
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | Europe [Member]
Concentration Risk, Percentage	63%	53%	56%	32%
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | Asia [Member]
Concentration Risk, Percentage	22%	22%	25%	51%

Note 15 - Segments and Geogra_4

Note 15 - Segments and Geographic Areas - Consolidated Assets and Long Lived Assets by Geographic Area (Details) - Geographic Concentration Risk [Member]	6 Months Ended	12 Months Ended
	Jun. 30, 2022	Dec. 31, 2021
Long-lived Assets [Member] | UNITED STATES
Percentage	33%	26%
Long-lived Assets [Member] | SWITZERLAND
Percentage	40%	34%
Long-lived Assets [Member] | ITALY
Percentage	20%	36%
Long-lived Assets [Member] | Other Countries in EMEA [Member]
Percentage	7%	4%
Long-lived Assets [Member] | Europe, Middle East, and Africa [Member]
Percentage	67%	74%
Long-lived Assets [Member] | Asia [Member]
Percentage	0%	0%
Long-lived Assets [Member] | All Countries [Member]
Percentage	100%	100%
Assets, Total [Member] | UNITED STATES
Percentage	77%	77%
Assets, Total [Member] | SWITZERLAND
Percentage	18%	16%
Assets, Total [Member] | ITALY
Percentage	3%	5%
Assets, Total [Member] | Other Countries in EMEA [Member]
Percentage	1%	1%
Assets, Total [Member] | Europe, Middle East, and Africa [Member]
Percentage	22%	22%
Assets, Total [Member] | Asia [Member]
Percentage	1%	1%
Assets, Total [Member] | All Countries [Member]
Percentage	100%	100%

Note 16 - Related Person Tran_2

Note 16 - Related Person Transactions (Details Textual) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Asensus Surgical Europe S.à.R.L [Member] | 1 Med S.A. [Member] | Service Supply Agreement [Member]
Related Party Transaction, Expenses from Transactions with Related Party	$ 68,000	$ 0	$ 141,000	$ 93,000