Document And Entity Information
Document And Entity Information - shares | 3 Months Ended | |
Mar. 31, 2023 | May 08, 2023 | |
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 | Q1 | |
Document Fiscal Year Focus | 2023 | |
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Mar. 31, 2023 | |
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 $0.001 par value per share | |
Trading Symbol | ASXC | |
Security Exchange Name | NYSEAMER | |
Entity Common Stock, Shares Outstanding | 239,465,556 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Operations and Comprehensive Loss (Unaudited) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Revenue: | ||
Revenue | $ 976 | $ 1,066 |
Cost of revenue: | ||
Cost of revenue | 2,947 | 1,823 |
Gross loss | (1,971) | (757) |
Operating Expenses: | ||
Research and development | 10,139 | 6,428 |
Sales and marketing | 4,553 | 3,719 |
General and administrative | 5,468 | 5,533 |
Amortization of intangible assets | 112 | 2,670 |
Change in fair value of contingent consideration | 105 | (154) |
Total Operating Expenses | 20,377 | 18,196 |
Operating Loss | (22,348) | (18,953) |
Other Income (Expense), net | ||
Interest income | 439 | 255 |
Interest expense | 0 | (200) |
Other expense, net | (218) | (146) |
Total Other Income (Expense), net | 221 | (91) |
Loss before income taxes | (22,127) | (19,044) |
Income tax expense | (91) | (84) |
Net loss | (22,218) | (19,128) |
Comprehensive loss: | ||
Net loss | (22,218) | (19,128) |
Foreign currency translation gain (loss) | 550 | (650) |
Unrealized gain (loss) on available-for-sale investments | 307 | (552) |
Comprehensive loss | $ (21,361) | $ (20,330) |
Net loss per common share attributable to common stockholders - basic and diluted (in dollars per share) | $ (0.09) | $ (0.08) |
Weighted average number of shares used in computing net loss per common share - basic and diluted (in shares) | 238,280 | 235,892 |
Product [Member] | ||
Revenue: | ||
Revenue | $ 293 | $ 347 |
Cost of revenue: | ||
Cost of revenue | 1,225 | 375 |
Service [Member] | ||
Revenue: | ||
Revenue | 195 | 308 |
Cost of revenue: | ||
Cost of revenue | 749 | 496 |
Lease [Member] | ||
Revenue: | ||
Revenue | 488 | 411 |
Cost of revenue: | ||
Cost of revenue | $ 973 | $ 952 |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Current Assets: | ||
Cash and cash equivalents | $ 18,737 | $ 6,329 |
Short-term investments, available-for-sale | 37,697 | 64,195 |
Accounts receivable, net | 658 | 2,256 |
Inventories | 8,844 | 8,284 |
Prepaid expenses | 3,326 | 3,584 |
Employee retention tax credit receivable | 554 | 554 |
Other current assets | 1,740 | 1,671 |
Total Current Assets | 71,556 | 86,873 |
Restricted cash | 1,142 | 1,141 |
Long-term investments, available-for-sale | 958 | 3,865 |
Inventories, net of current portion | 5,198 | 5,469 |
Property and equipment, net | 8,972 | 9,542 |
Intellectual property, net | 1,506 | 1,576 |
Net deferred tax assets | 171 | 174 |
Operating lease right-of-use assets, net | 4,769 | 4,950 |
Other long-term assets | 2,251 | 2,463 |
Total Assets | 96,523 | 116,053 |
Current Liabilities: | ||
Accounts payable | 4,972 | 3,348 |
Accrued employee compensation and benefits | 3,391 | 4,508 |
Accrued expenses and other current liabilities | 1,283 | 1,293 |
Operating lease liabilities - current portion | 775 | 800 |
Deferred revenue | 456 | 465 |
Total Current Liabilities | 10,877 | 10,414 |
Long-Term Liabilities: | ||
Contingent consideration | 1,361 | 1,256 |
Noncurrent operating lease liabilities | 4,568 | 4,738 |
Total Liabilities | 16,806 | 16,408 |
Commitments and Contingencies (Note 13) | ||
Stockholders' Equity: | ||
Common stock $0.001 par value, 750,000,000 shares authorized at March 31, 2023 and December 31, 2022; 239,341,570 and 236,895,440 issued and outstanding at March 31, 2023 and December 31, 2022, respectively | 239 | 237 |
Preferred stock, $0.01 par value, 25,000,000 shares authorized, no shares issued and outstanding at March 31, 2023 and December 31, 2022 | 0 | 0 |
Additional paid-in capital | 964,162 | 962,731 |
Accumulated deficit | (883,153) | (860,935) |
Accumulated other comprehensive loss | (1,531) | (2,388) |
Total Stockholders' Equity | 79,717 | 99,645 |
Total Liabilities and Stockholders' Equity | 96,523 | 116,053 |
Intellectual Property [Member] | ||
Current Assets: | ||
Intellectual property, net | $ 1,506 | $ 1,576 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares | Mar. 31, 2023 | Dec. 31, 2022 |
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) | 239,341,570 | 236,895,440 |
Common stock, shares outstanding (in shares) | 239,341,570 | 236,895,440 |
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, Common [Member] | Additional Paid-in Capital [Member] | Retained Earnings [Member] | AOCI Attributable to Parent [Member] | Total |
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 | (1,202) | (1,202) | ||
Net loss | $ 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, 2022 | 236,895,000 | 0 | ||||
Balance at Dec. 31, 2022 | $ 237 | $ 0 | 962,731 | (860,935) | (2,388) | 99,645 |
Stock-based compensation | $ 0 | 1,916 | 0 | 0 | $ 1,916 | |
Exercise of stock options (in shares) | 13,000 | 0 | 13,300 | |||
Exercise of stock options | $ 0 | $ 0 | 5 | 0 | 0 | $ 5 |
Award of restricted stock units (in shares) | 2,434,000 | |||||
Award of restricted stock units | $ 2 | 2 | ||||
Return of common stock to pay withholding taxes on restricted stock (in shares) | 0 | 649,000 | ||||
Return of common stock to pay withholding taxes on restricted stock | $ 0 | $ 1 | (490) | 0 | 0 | (489) |
Cancellation of treasury stock (in shares) | 0 | (649,000) | ||||
Cancellation of treasury stock | $ 0 | $ (1) | 0 | 0 | 0 | (1) |
Other comprehensive loss | 0 | 0 | 0 | 0 | 857 | 857 |
Net loss | $ 0 | $ 0 | (22,218) | 0 | (22,218) | |
Balance (in shares) at Mar. 31, 2023 | 239,342,000 | 0 | ||||
Balance at Mar. 31, 2023 | $ 239 | $ 0 | $ 964,162 | $ (883,153) | $ (1,531) | $ 79,717 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Operating Activities: | ||
Net loss | $ (22,218) | $ (19,128) |
Adjustments to reconcile net loss to net cash and cash equivalents used in operating activities: | ||
Depreciation | 813 | 869 |
Amortization of intangible assets | 112 | 2,670 |
Amortization of discounts and premiums on investments, net | (89) | 215 |
Stock-based compensation | 1,916 | 2,245 |
Deferred tax expense | 91 | 84 |
Bad debt expense | 0 | 177 |
Change in inventory reserves | (374) | (180) |
Change in fair value of contingent consideration | 105 | (154) |
Changes in operating assets and liabilities: | ||
Accounts receivable | 1,607 | 25 |
Inventories | 203 | (1,440) |
Operating lease right-of-use assets | 187 | 197 |
Prepaid expenses | 250 | 201 |
Other current and long-term assets | (27) | (487) |
Accounts payable | 1,608 | 74 |
Accrued employee compensation and benefits | (1,120) | (1,043) |
Accrued expenses and other current liabilities | (93) | (107) |
Deferred revenue | (13) | (1) |
Operating lease liabilities | (206) | (160) |
Net cash and cash equivalents used in operating activities | (17,248) | (15,943) |
Investing Activities: | ||
Purchase of available-for-sale investments | (2,949) | (5,967) |
Proceeds from maturities of available-for-sale investments | 32,750 | 29,258 |
Purchase of property and equipment | (64) | (246) |
Net cash and cash equivalents provided by investing activities | 29,737 | 23,045 |
Financing Activities: | ||
Taxes paid related to net share settlement of vesting of restricted stock units | (488) | (348) |
Proceeds from exercise of stock options and warrants | 5 | 12 |
Net cash and cash equivalents used in financing activities | (483) | (336) |
Effect of exchange rate changes on cash and cash equivalents | 403 | (45) |
Net increase in cash, cash equivalents and restricted cash | 12,409 | 6,721 |
Cash, cash equivalents and restricted cash, beginning of period | 7,470 | 19,283 |
Cash, cash equivalents and restricted cash, end of period | 19,879 | 26,004 |
Supplemental Disclosure for Cash Flow Information | ||
Cash paid for leases | 330 | 300 |
Cash paid for taxes | 190 | 29 |
Supplemental Schedule of Non-cash Investing and Financing Activities: | ||
Transfer of inventories to property and equipment | 112 | 160 |
Lease liabilities arising from obtaining right-of-use assets | $ 45 | $ 0 |
Note 1 - Description of the Bus
Note 1 - Description of the Business | 3 Months Ended |
Mar. 31, 2023 | |
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 what we are calling “Performance-Guided Surgery™” by unlocking clinical intelligence for surgeons to enable consistently superior outcomes and a new standard of surgery. Based upon the foundations of digital laparoscopy and the Senhance® Surgical System, the Company is developing the LUNA™ Surgical System, a next generation robotic and instrument system as a foundation of its digital surgery solution. These systems will be powered by the Intelligent Surgical Unit™(ISU™) to increase surgeon control and reduce surgical variability. With the addition of machine vision, augmented intelligence, and deep learning capabilities throughout the surgical experience, we intend to holistically address the current clinical, cognitive and economic shortcomings that drive surgical outcomes and value-based healthcare. The Company continues market development for and commercialization of the Senhance 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 | 3 Months Ended |
Mar. 31, 2023 | |
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 2022 10 Going Concern The Company's condensed consolidated financial statements are prepared using U.S. GAAP applicable to a going concern, which contemplate the realization of assets and liquidation of liabilities in the normal course of business. The Company had an accumulated deficit of $883.2 million and working capital of $60.7 million as of March 31, 2023. not The Company will need to obtain additional financing to proceed with its business plan. Management's plan to obtain additional resources for the Company may one not may 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.àr.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: the historical lack of profitability; the Company’s ability to raise additional capital; its ability to successfully develop, clinically test and commercialize its products and products in development; 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, 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 2022 10 Impact of Recently Issued Accounting Standards The Company has evaluated issued ASUs not not |
Note 3 - Revenue Recognition
Note 3 - Revenue Recognition | 3 Months Ended |
Mar. 31, 2023 | |
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 March 31, 2023 2022 (in thousands) U.S. Systems $ - $ - Instruments and accessories 60 64 Services 75 74 Leases 71 113 Total U.S. revenue 206 251 Outside of U.S. ("OUS") Systems - - Instruments and accessories 233 283 Services 120 234 Leases 417 298 Total OUS revenue 770 815 Total Systems - - Instruments and accessories 293 347 Services 195 308 Leases 488 411 Total revenue $ 976 $ 1,066 Remaining Performance Obligations The transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which the revenue has not March 31, 2023 one four Contract Assets and Liabilities 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 March 31, 2023 2022 The following information summarizes the Company’s contract assets and liabilities: As of March 31, 2023 December 31, 2022 (in thousands) Contract Assets $ 81 $ 116 Deferred Revenue $ 456 $ 465 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 Senhance 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 Senhance System. For the three March 31, 2023, 2022, not Accounts Receivable Accounts receivable are recorded at net realizable value, which includes an allowance for expected credit losses. The allowance for expected credit losses is based on the Company’s assessment of the 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 March 31, 2023 December 31, 2022, three March 31, 2023 2022, |
Note 4 - Fair Value
Note 4 - Fair Value | 3 Months Ended |
Mar. 31, 2023 | |
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 March 31, 2023 (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) $ 18,737 $ - $ - $ 18,737 Restricted cash 1,142 - - 1,142 Short-term investments - 37,697 - 37,697 Long-term investments - 958 - 958 Total assets measured at fair value $ 19,879 $ 38,655 $ - $ 58,534 Liabilities measured at fair value Contingent consideration $ - $ - $ 1,361 $ 1,361 Total liabilities measured at fair value $ - $ - $ 1,361 $ 1,361 ( 1 90 December 31, 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) $ 6,329 $ - $ - $ 6,329 Restricted cash 1,141 - - 1,141 Short-term investments - 64,195 - 64,195 Long-term investments - 3,865 - 3,865 Total assets measured at fair value $ 7,470 $ 68,060 $ - $ 75,530 Liabilities measured at fair value Contingent consideration $ - $ - $ 1,256 $ 1,256 Total liabilities measured at fair value $ - $ - $ 1,256 $ 1,256 ( 1 90 The carrying values of accounts receivable, prepaid expenses, employee retention tax credit receivables, other current assets, accounts payable, accrued employee compensation and benefits, accrued expenses and other current liabilities, and deferred revenue as of March 31, 2023, December 31, 2022, The Company’s financial liabilities consisted of contingent consideration payable to Three Heads Investment S.r.l., 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 March 31, 2023 December 31, 2022: Valuation Methodology Significant Unobservable Input March 31, 2023 December 31, 2022 Contingent consideration Probability weighted income approach Milestone dates 2032 2032 Discount rate 16.0% 16.5% Revenue volatility 40.0% 45.0% EUR-to-USD exchange rate 1.09 1.07 The following table presents the current and long-term portion of the contingent consideration for the three March 31, 2023 3 three March 31, 2023 2022: Fair Value Measurement at Reporting Date (Level 3) (in thousands) Contingent consideration Balance at December 31, 2021 $ 2,371 Change in fair value (154 ) Balance at March 31, 2022 $ 2,217 Balance at December 31, 2022 $ 1,256 Change in fair value 105 Balance at March 31, 2023 $ 1,361 Current portion $ - Long-term portion 1,361 Balance at March 31, 2023 $ 1,361 |
Note 5 - Investments, Available
Note 5 - Investments, Available-for-sale | 3 Months Ended |
Mar. 31, 2023 | |
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 cumulative unrealized gains and losses determined on an individual investment security basis and included in other comprehensive loss are as follows: March 31, 2023 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commercial Paper $ 5,442 $ - $ (16 ) $ 5,426 $ 5,426 $ - Corporate Bonds 29,459 2 (178 ) 29,283 28,325 958 U.S. Treasuries 2,953 - (1 ) 2,952 2,952 - U.S. Government Agencies 999 - (5 ) 994 994 - Total Investments $ 38,853 $ 2 $ (200 ) $ 38,655 $ 37,697 $ 958 December 31, 2022 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commercial Paper $ 12,364 $ - $ (49 ) $ 12,315 $ 12,315 $ - Corporate Bonds 55,201 - (447 ) 54,754 50,889 3,865 U.S. Government Agencies 999 - (8 ) 991 991 - Total Investments $ 68,564 $ - $ (504 ) $ 68,060 $ 64,195 $ 3,865 The following table summarizes the contractual maturities of the Company’s available-for-sale investments: March 31, 2023 (in thousands) Amortized Cost Fair Value Mature in less than one year $ 37,897 $ 37,697 Mature in one to two years 956 958 Total $ 38,853 $ 38,655 Actual maturities may no three March 31, 2023 2022. |
Note 6 - Inventories
Note 6 - Inventories | 3 Months Ended |
Mar. 31, 2023 | |
Notes to Financial Statements | |
Inventory Disclosure [Text Block] | 6. Inventories The components of inventories are as follows: March 31, 2023 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 16,101 $ (4,175 ) $ 11,926 Raw materials 4,617 (2,501 ) 2,116 Total inventories $ 20,718 $ (6,676 ) $ 14,042 Current Portion $ 10,013 $ (1,169 ) $ 8,844 Long-term portion 10,705 (5,507 ) 5,198 Total inventories $ 20,718 $ (6,676 ) $ 14,042 December 31, 2022 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 15,337 $ (4,129 ) $ 11,208 Raw materials 4,718 (2,173 ) 2,545 Total inventories $ 20,055 $ (6,302 ) $ 13,753 Current Portion $ 9,399 $ (1,115 ) $ 8,284 Long-term portion 10,656 (5,187 ) 5,469 Total inventories $ 20,055 $ (6,302 ) $ 13,753 |
Note 7 - Intellectual Property
Note 7 - Intellectual Property | 3 Months Ended |
Mar. 31, 2023 | |
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: March 31, 2023 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (66,646 ) $ (853 ) $ 1,339 Technology and patents purchased 400 (248 ) 15 167 Total intellectual property $ 69,238 $ (66,894 ) $ (838 ) $ 1,506 December 31, 2022 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (66,562 ) $ (874 ) $ 1,402 Technology and patents purchased 400 (239 ) 13 174 Total intellectual property $ 69,238 $ (66,801 ) $ (861 ) $ 1,576 The weighted average remaining useful life of the developed technology and technology and patents purchased was 3.9 years and 4.1 years, respectively, as of March 31, 2023. December 31, 2022. |
Note 8 - Leases
Note 8 - Leases | 3 Months Ended |
Mar. 31, 2023 | |
Notes to Financial Statements | |
Lessee, Operating Leases [Text Block] | 8. Leases Lessee Information 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 March 31, 2023 2022 (in thousands) Long-term Operating $ 451 $ 398 Short-term Operating - - Total Operating lease expense $ 451 $ 398 Supplemental balance sheet information related to operating leases was as follows: March 31, 2023 December 31, 2022 Weighted-average remaining lease term (in years) 6.7 6.8 Weighted-average discount rate 8.4% 8.4% Incremental borrowing rate 7.07% - 14.5% 6.1% - 14.5% Maturities of operating lease obligations as of March 31, 2023 Fiscal Year 2023 $ 897 2024 1,142 2025 1,061 2026 847 2027 780 Thereafter 2,199 Total minimum lease payments $ 6,926 Less: Amount of lease payments representing interest (1,583 ) Present value of future minimum lease payments $ 5,343 |
Note 9 - Income Taxes
Note 9 - Income Taxes | 3 Months Ended |
Mar. 31, 2023 | |
Notes to Financial Statements | |
Income Tax Disclosure [Text Block] | 9. Income Taxes Income taxes have been accounted for using the asset and liability method in accordance with ASC 740 December 31, 2023. not three March 31, 2023 2022 The Company incurred losses for the three March 31, 2023, December 31, 2023. not The total tax expense during the three March 31, 2023 2022, At March 31, 2023 The FASB Staff Q&A, Topic 740, No. 5, not 2023; no three March 31, 2023 2022, |
Note 10 - Stock-based Compensat
Note 10 - Stock-based Compensation | 3 Months Ended |
Mar. 31, 2023 | |
Notes to Financial Statements | |
Share-Based Payment Arrangement [Text Block] | 10. Stock-Based Compensation Stock Options The following table summarizes the Company’s stock option activity, including grants to non-employees, for the three March 31, 2023: Number of Shares Weighted- Average Exercise Price Weighted-Average Remaining Contractual Term (Years) Balance at December 31, 2022 7,584,967 $ 4.22 5.31 Granted 2,748,415 0.73 Forfeited - - Cancelled (913 ) 4.21 Exercised (13,300 ) 0.38 Balance at March 31, 2023 10,319,169 $ 3.30 5.54 The following table summarizes information about stock options outstanding at March 31, 2023: Number of Shares Weighted- Average Exercise Price Weighted-Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (Millions) Exercisable at March 31, 2023 4,843,264 $ 5.96 4.80 $ 0.4 Vested or expected to vest at March 31, 2023 9,645,630 $ 3.47 5.47 $ 0.6 The fair value of options granted were estimated using the Black-Scholes-Merton option pricing model based on the assumptions in the table below: Three Months Ended March 31, 2023 2022 Expected dividend yield 0% 0% Expected volatility 124% - 126% 131% - 133% Risk-free interest rate 3.73% - 4.14% 1.25% - 1.94% Expected life (in years) 4.3 - 4.5 4.3 - 4.5 Restricted Stock Units The following is a summary of the restricted stock units activity, including performance restricted stock units, for the three March 31, 2023: Number of Restricted Stock Units Outstanding Weighted- Average Grant Date Fair Value Unvested December 31, 2022 8,483,491 $ 1.04 Granted 7,340,630 0.73 Vested (3,082,354 ) 1.18 Forfeited (84,673 ) 1.13 Unvested March 31, 2023 12,657,094 $ 0.83 Performance Restricted Stock Units In 2023 2022, December 31, 2023 October 1, 2023, 2023 2022 2022, 2022 three not 2023. Stock-based Compensation Expense The following table summarizes non-cash stock-based compensation expense by award type for the three March 31, 2023 2022: Three Months Ended March 31, 2023 2022 (in thousands) Stock options $ 665 $ 978 Restricted stock units 859 883 Performance restricted stock units 392 384 $ 1,916 $ 2,245 As of March 31, 2023, March 31, 2023, |
Note 11 - Equity Offerings
Note 11 - Equity Offerings | 3 Months Ended |
Mar. 31, 2023 | |
Notes to Financial Statements | |
Equity [Text Block] | 11. Equity Offerings 2022 March 18, 2022, “2022 “2022 2022 three March 31, 2023 2022, |
Note 12 - Basic and Diluted Net
Note 12 - Basic and Diluted Net Loss Per Share | 3 Months Ended |
Mar. 31, 2023 | |
Notes to Financial Statements | |
Earnings Per Share [Text Block] | 12. 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 March 31, 2023 2022 Potential common shares not March 31, 2023 2022 Stock options 10,319,169 6,766,520 Stock warrants 1,021,076 1,120,300 Nonvested restricted stock units 12,657,094 7,299,111 Total 23,997,339 15,185,931 |
Note 13 - Commitments and Conti
Note 13 - Commitments and Contingencies | 3 Months Ended |
Mar. 31, 2023 | |
Notes to Financial Statements | |
Commitments and Contingencies Disclosure [Text Block] | 13. Commitments and Contingencies License and Supply Agreements The Company has purchase orders with various suppliers for certain tooling, supplies, contract engineering and research services. Commitments related to these agreements and purchase orders are as follows (in thousands): Fiscal Year 2023 $ 8,058 2024 439 2025 315 2026 303 Total commitments $ 9,115 |
Note 14 - Segments and Geograph
Note 14 - Segments and Geographic Areas | 3 Months Ended |
Mar. 31, 2023 | |
Notes to Financial Statements | |
Segment Reporting Disclosure [Text Block] | 14. Segments and Geographic Areas The Company operates in one business segment—the research, development and sale of medical devices 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: March 31, 2023 Long-Lived Assets Total Assets U.S. 36 % 71 % EMEA Switzerland 45 % 24 % Italy 8 % 2 % Other 8 % 2 % Total EMEA 61 % 28 % Asia 3 % 1 % Total 100 % 100 % December 31, 2022 Long-Lived Assets Total Assets U.S. 35 % 72 % EMEA Switzerland 46 % 24 % Italy 8 % 2 % Other 8 % 1 % Total EMEA 62 % 27 % Asia 3 % 1 % Total 100 % 100 % The following table presents sales by geographic area based on the country in which the customer is based. Three Months Ended March 31, 2023 2022 US 21 % 24 % EMEA 58 % 48 % Asia 21 % 28 % Total 100 % 100 % |
Note 15 - Related Party Transac
Note 15 - Related Party Transactions | 3 Months Ended |
Mar. 31, 2023 | |
Notes to Financial Statements | |
Related Party Transactions Disclosure [Text Block] | 15. Related Party Transactions In March 2018, 1 1 three March 31, 2023 2022, |
Significant Accounting Policies
Significant Accounting Policies (Policies) | 3 Months Ended |
Mar. 31, 2023 | |
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 2022 10 |
Substantial Doubt about Going Concern [Policy Text Block] | Going Concern The Company's condensed consolidated financial statements are prepared using U.S. GAAP applicable to a going concern, which contemplate the realization of assets and liquidation of liabilities in the normal course of business. The Company had an accumulated deficit of $883.2 million and working capital of $60.7 million as of March 31, 2023. not The Company will need to obtain additional financing to proceed with its business plan. Management's plan to obtain additional resources for the Company may one not may |
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.àr.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: the historical lack of profitability; the Company’s ability to raise additional capital; its ability to successfully develop, clinically test and commercialize its products and products in development; 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, 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 2022 10 |
New Accounting Pronouncements, Policy [Policy Text Block] | Impact of Recently Issued Accounting Standards The Company has evaluated issued ASUs not not |
Note 3 - Revenue Recognition (T
Note 3 - Revenue Recognition (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Notes Tables | |
Disaggregation of Revenue [Table Text Block] | Three Months Ended March 31, 2023 2022 (in thousands) U.S. Systems $ - $ - Instruments and accessories 60 64 Services 75 74 Leases 71 113 Total U.S. revenue 206 251 Outside of U.S. ("OUS") Systems - - Instruments and accessories 233 283 Services 120 234 Leases 417 298 Total OUS revenue 770 815 Total Systems - - Instruments and accessories 293 347 Services 195 308 Leases 488 411 Total revenue $ 976 $ 1,066 |
Contract with Customer, Contract Asset, Contract Liability, and Receivable [Table Text Block] | As of March 31, 2023 December 31, 2022 (in thousands) Contract Assets $ 81 $ 116 Deferred Revenue $ 456 $ 465 |
Note 4 - Fair Value (Tables)
Note 4 - Fair Value (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Notes Tables | |
Fair Value, Assets Measured on Recurring Basis [Table Text Block] | March 31, 2023 (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) $ 18,737 $ - $ - $ 18,737 Restricted cash 1,142 - - 1,142 Short-term investments - 37,697 - 37,697 Long-term investments - 958 - 958 Total assets measured at fair value $ 19,879 $ 38,655 $ - $ 58,534 Liabilities measured at fair value Contingent consideration $ - $ - $ 1,361 $ 1,361 Total liabilities measured at fair value $ - $ - $ 1,361 $ 1,361 December 31, 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) $ 6,329 $ - $ - $ 6,329 Restricted cash 1,141 - - 1,141 Short-term investments - 64,195 - 64,195 Long-term investments - 3,865 - 3,865 Total assets measured at fair value $ 7,470 $ 68,060 $ - $ 75,530 Liabilities measured at fair value Contingent consideration $ - $ - $ 1,256 $ 1,256 Total liabilities measured at fair value $ - $ - $ 1,256 $ 1,256 |
Fair Value Measurement Inputs and Valuation Techniques [Table Text Block] | Valuation Methodology Significant Unobservable Input March 31, 2023 December 31, 2022 Contingent consideration Probability weighted income approach Milestone dates 2032 2032 Discount rate 16.0% 16.5% Revenue volatility 40.0% 45.0% EUR-to-USD exchange rate 1.09 1.07 |
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block] | Fair Value Measurement at Reporting Date (Level 3) (in thousands) Contingent consideration Balance at December 31, 2021 $ 2,371 Change in fair value (154 ) Balance at March 31, 2022 $ 2,217 Balance at December 31, 2022 $ 1,256 Change in fair value 105 Balance at March 31, 2023 $ 1,361 Current portion $ - Long-term portion 1,361 Balance at March 31, 2023 $ 1,361 |
Note 5 - Investments, Availab_2
Note 5 - Investments, Available-for-sale (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Notes Tables | |
Debt Securities, Available-for-Sale [Table Text Block] | March 31, 2023 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commercial Paper $ 5,442 $ - $ (16 ) $ 5,426 $ 5,426 $ - Corporate Bonds 29,459 2 (178 ) 29,283 28,325 958 U.S. Treasuries 2,953 - (1 ) 2,952 2,952 - U.S. Government Agencies 999 - (5 ) 994 994 - Total Investments $ 38,853 $ 2 $ (200 ) $ 38,655 $ 37,697 $ 958 December 31, 2022 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commercial Paper $ 12,364 $ - $ (49 ) $ 12,315 $ 12,315 $ - Corporate Bonds 55,201 - (447 ) 54,754 50,889 3,865 U.S. Government Agencies 999 - (8 ) 991 991 - Total Investments $ 68,564 $ - $ (504 ) $ 68,060 $ 64,195 $ 3,865 |
Investments Classified by Contractual Maturity Date [Table Text Block] | March 31, 2023 (in thousands) Amortized Cost Fair Value Mature in less than one year $ 37,897 $ 37,697 Mature in one to two years 956 958 Total $ 38,853 $ 38,655 |
Note 6 - Inventories (Tables)
Note 6 - Inventories (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Notes Tables | |
Schedule of Inventory, Current [Table Text Block] | March 31, 2023 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 16,101 $ (4,175 ) $ 11,926 Raw materials 4,617 (2,501 ) 2,116 Total inventories $ 20,718 $ (6,676 ) $ 14,042 Current Portion $ 10,013 $ (1,169 ) $ 8,844 Long-term portion 10,705 (5,507 ) 5,198 Total inventories $ 20,718 $ (6,676 ) $ 14,042 December 31, 2022 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 15,337 $ (4,129 ) $ 11,208 Raw materials 4,718 (2,173 ) 2,545 Total inventories $ 20,055 $ (6,302 ) $ 13,753 Current Portion $ 9,399 $ (1,115 ) $ 8,284 Long-term portion 10,656 (5,187 ) 5,469 Total inventories $ 20,055 $ (6,302 ) $ 13,753 |
Note 7 - Intellectual Property
Note 7 - Intellectual Property (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Notes Tables | |
Schedule of Finite-Lived Intangible Assets [Table Text Block] | March 31, 2023 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (66,646 ) $ (853 ) $ 1,339 Technology and patents purchased 400 (248 ) 15 167 Total intellectual property $ 69,238 $ (66,894 ) $ (838 ) $ 1,506 December 31, 2022 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (66,562 ) $ (874 ) $ 1,402 Technology and patents purchased 400 (239 ) 13 174 Total intellectual property $ 69,238 $ (66,801 ) $ (861 ) $ 1,576 |
Note 8 - Leases (Tables)
Note 8 - Leases (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Notes Tables | |
Lease, Cost [Table Text Block] | Three Months Ended March 31, 2023 2022 (in thousands) Long-term Operating $ 451 $ 398 Short-term Operating - - Total Operating lease expense $ 451 $ 398 |
Lessee, Operating Lease, Disclosure [Table Text Block] | March 31, 2023 December 31, 2022 Weighted-average remaining lease term (in years) 6.7 6.8 Weighted-average discount rate 8.4% 8.4% Incremental borrowing rate 7.07% - 14.5% 6.1% - 14.5% |
Lessee, Operating Lease, Liability, to be Paid, Maturity [Table Text Block] | Fiscal Year 2023 $ 897 2024 1,142 2025 1,061 2026 847 2027 780 Thereafter 2,199 Total minimum lease payments $ 6,926 Less: Amount of lease payments representing interest (1,583 ) Present value of future minimum lease payments $ 5,343 |
Note 10 - Stock-based Compens_2
Note 10 - Stock-based Compensation (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
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, 2022 7,584,967 $ 4.22 5.31 Granted 2,748,415 0.73 Forfeited - - Cancelled (913 ) 4.21 Exercised (13,300 ) 0.38 Balance at March 31, 2023 10,319,169 $ 3.30 5.54 |
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 March 31, 2023 4,843,264 $ 5.96 4.80 $ 0.4 Vested or expected to vest at March 31, 2023 9,645,630 $ 3.47 5.47 $ 0.6 |
Schedule of Share-Based Payment Award, Stock Options, Valuation Assumptions [Table Text Block] | Three Months Ended March 31, 2023 2022 Expected dividend yield 0% 0% Expected volatility 124% - 126% 131% - 133% Risk-free interest rate 3.73% - 4.14% 1.25% - 1.94% Expected life (in years) 4.3 - 4.5 4.3 - 4.5 |
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, 2022 8,483,491 $ 1.04 Granted 7,340,630 0.73 Vested (3,082,354 ) 1.18 Forfeited (84,673 ) 1.13 Unvested March 31, 2023 12,657,094 $ 0.83 |
Share-Based Payment Arrangement, Cost by Plan [Table Text Block] | Three Months Ended March 31, 2023 2022 (in thousands) Stock options $ 665 $ 978 Restricted stock units 859 883 Performance restricted stock units 392 384 $ 1,916 $ 2,245 |
Note 12 - Basic and Diluted N_2
Note 12 - Basic and Diluted Net Loss Per Share (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Notes Tables | |
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block] | March 31, 2023 2022 Stock options 10,319,169 6,766,520 Stock warrants 1,021,076 1,120,300 Nonvested restricted stock units 12,657,094 7,299,111 Total 23,997,339 15,185,931 |
Note 13 - Commitments and Con_2
Note 13 - Commitments and Contingencies (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Notes Tables | |
Contractual Obligation, Fiscal Year Maturity [Table Text Block] | Fiscal Year 2023 $ 8,058 2024 439 2025 315 2026 303 Total commitments $ 9,115 |
Note 14 - Segments and Geogra_2
Note 14 - Segments and Geographic Areas (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Notes Tables | |
Long-Lived Assets by Geographic Areas [Table Text Block] | March 31, 2023 Long-Lived Assets Total Assets U.S. 36 % 71 % EMEA Switzerland 45 % 24 % Italy 8 % 2 % Other 8 % 2 % Total EMEA 61 % 28 % Asia 3 % 1 % Total 100 % 100 % December 31, 2022 Long-Lived Assets Total Assets U.S. 35 % 72 % EMEA Switzerland 46 % 24 % Italy 8 % 2 % Other 8 % 1 % Total EMEA 62 % 27 % Asia 3 % 1 % Total 100 % 100 % |
Revenue from External Customers by Geographic Areas [Table Text Block] | Three Months Ended March 31, 2023 2022 US 21 % 24 % EMEA 58 % 48 % Asia 21 % 28 % Total 100 % 100 % |
Note 2 - Summary of Significa_2
Note 2 - Summary of Significant Accounting Policies (Details Textual) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Retained Earnings (Accumulated Deficit) | $ (883,153) | $ (860,935) |
Working Capital | $ 60,700 |
Note 3 - Revenue Recognition 1
Note 3 - Revenue Recognition 1 (Details Textual) - USD ($) $ in Millions | 3 Months Ended | ||
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | |
Contract with Customer, Liability, Revenue Recognized | $ 0.2 | $ 0.2 | |
Accounts Receivable, Allowance for Credit Loss | $ 1.6 | $ 1.6 |
Note 3 - Revenue Recognition 2
Note 3 - Revenue Recognition 2 (Details Textual) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2023-04-01 $ in Millions | Mar. 31, 2023 USD ($) |
Revenue, Remaining Performance Obligation, Amount | $ 0.9 |
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 | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Revenue | $ 976 | $ 1,066 |
UNITED STATES | ||
Revenue | 206 | 251 |
Non-US [Member] | ||
Revenue | 770 | 815 |
Systems [Member] | ||
Revenue | 0 | 0 |
Systems [Member] | UNITED STATES | ||
Revenue | 0 | 0 |
Systems [Member] | Non-US [Member] | ||
Revenue | 0 | 0 |
Instruments and Accessories [Member] | ||
Revenue | 293 | 347 |
Instruments and Accessories [Member] | UNITED STATES | ||
Revenue | 60 | 64 |
Instruments and Accessories [Member] | Non-US [Member] | ||
Revenue | 233 | 283 |
Service [Member] | ||
Revenue | 195 | 308 |
Service [Member] | UNITED STATES | ||
Revenue | 75 | 74 |
Service [Member] | Non-US [Member] | ||
Revenue | 120 | 234 |
Lease [Member] | ||
Revenue | 488 | 411 |
Lease [Member] | UNITED STATES | ||
Revenue | 71 | 113 |
Lease [Member] | Non-US [Member] | ||
Revenue | $ 417 | $ 298 |
Note 3 - Revenue Recognition _2
Note 3 - Revenue Recognition - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Contract Assets | $ 81 | $ 116 |
Deferred Revenue | $ 456 | $ 465 |
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 | Mar. 31, 2023 | Dec. 31, 2022 | |
Cash and cash equivalents | [1] | $ 18,737 | $ 6,329 |
Restricted cash | 1,142 | 1,141 | |
Short-term investments | 37,697 | 64,195 | |
Long-term investments | 958 | 3,865 | |
Total assets measured at fair value | 58,534 | 75,530 | |
Contingent consideration | 1,361 | 1,256 | |
Total liabilities measured at fair value | 1,361 | 1,256 | |
Fair Value, Inputs, Level 1 [Member] | |||
Cash and cash equivalents | [1] | 18,737 | 6,329 |
Restricted cash | 1,142 | 1,141 | |
Short-term investments | 0 | 0 | |
Long-term investments | 0 | 0 | |
Total assets measured at fair value | 19,879 | 7,470 | |
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 | 37,697 | 64,195 | |
Long-term investments | 958 | 3,865 | |
Total assets measured at fair value | 38,655 | 68,060 | |
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 | 1,361 | 1,256 | |
Total liabilities measured at fair value | $ 1,361 | $ 1,256 | |
[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] | Mar. 31, 2023 | Dec. 31, 2022 |
Measurement Input, Discount Rate [Member] | ||
Contingent consideration, measurement input | 0.160 | 0.165 |
Measurement Input, Price Volatility [Member] | ||
Contingent consideration, measurement input | 0.400 | 0.450 |
Measurement Input, Currency Exchange Rate [Member] | ||
Contingent consideration, measurement input | 1.09 | 1.07 |
Note 4 - Fair Value - Summary_2
Note 4 - Fair Value - Summary of Change in Fair Value for Warrants and Contingent Consideration (Details) - Warrant [Member] - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Balance | $ 1,256 | $ 2,371 |
Change in fair value | 105 | (154) |
Balance | 1,361 | $ 2,217 |
Current portion | 0 | |
Long-term portion | $ 1,361 |
Note 5 - Investments, Availab_3
Note 5 - Investments, Available-for-sale (Details Textual) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
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 | Mar. 31, 2023 | Dec. 31, 2022 |
Amortized Cost | $ 38,853 | $ 68,564 |
Unrealized Gain | 2 | 0 |
Unrealized Loss | (200) | (504) |
Fair Value | 38,655 | 68,060 |
Short-term investments | 37,697 | 64,195 |
Long-term investments | 958 | 3,865 |
Commercial Paper [Member] | ||
Amortized Cost | 5,442 | 12,364 |
Unrealized Gain | 0 | 0 |
Unrealized Loss | (16) | (49) |
Fair Value | 5,426 | 12,315 |
Short-term investments | 5,426 | 12,315 |
Long-term investments | 0 | 0 |
Corporate Debt Securities [Member] | ||
Amortized Cost | 29,459 | 55,201 |
Unrealized Gain | 2 | 0 |
Unrealized Loss | (178) | (447) |
Fair Value | 29,283 | 54,754 |
Short-term investments | 28,325 | 50,889 |
Long-term investments | 958 | 3,865 |
US Treasury Securities [Member] | ||
Amortized Cost | 2,953 | |
Unrealized Gain | 0 | |
Unrealized Loss | (1) | |
Fair Value | 2,952 | |
Short-term investments | 2,952 | |
Long-term investments | 0 | |
US Government Agencies Debt Securities [Member] | ||
Amortized Cost | 999 | 999 |
Unrealized Gain | 0 | 0 |
Unrealized Loss | (5) | (8) |
Fair Value | 994 | 991 |
Short-term investments | 994 | 991 |
Long-term investments | $ 0 | $ 0 |
Note 5 - Investments, Availab_5
Note 5 - Investments, Available-for-sale - Contractual Maturities (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Mature in less than one year, amortized cost | $ 37,897 | |
Mature in less than one year, fair value | 37,697 | |
Mature in one to two years, amortized cost | 956 | |
Mature in one to two years, fair value | 958 | |
Total, amortized cost | 38,853 | $ 68,564 |
Total, fair value | $ 38,655 | $ 68,060 |
Note 6 - Inventories - Componen
Note 6 - Inventories - Components of Inventories (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Finished goods, gross | $ 16,101 | $ 15,337 |
Finished goods, reserve | (4,175) | (4,129) |
Finished goods, net | 11,926 | 11,208 |
Raw materials, gross | 4,617 | 4,718 |
Raw materials, reserve | (2,501) | (2,173) |
Raw materials, net | 2,116 | 2,545 |
Total inventories, gross | 20,718 | 20,055 |
Total inventories, reserve | (6,676) | (6,302) |
Total inventories, net | 14,042 | 13,753 |
Current Portion, gross | 10,013 | 9,399 |
Current Portion, reserve | (1,169) | (1,115) |
Inventories | 8,844 | 8,284 |
Long-term portion, gross | 10,705 | 10,656 |
Long-term portion, reserve | (5,507) | (5,187) |
Inventories, net of current portion | $ 5,198 | $ 5,469 |
Note 7 - Intellectual Propert_2
Note 7 - Intellectual Property (Details Textual) - Weighted Average [Member] | Mar. 31, 2023 | Dec. 31, 2022 |
Developed Technology Rights [Member] | ||
Finite-Lived Intangible Assets, Remaining Amortization Period (Year) | 3 years 10 months 24 days | 4 years 2 months 12 days |
Technology-Based Intangible Assets [Member] | ||
Finite-Lived Intangible Assets, Remaining Amortization Period (Year) | 4 years 1 month 6 days | 4 years 3 months 18 days |
Note 7 - Intellectual Propert_3
Note 7 - Intellectual Property - Intellectual Property (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Finite-Lived Intangible Assets, Gross | $ 69,238 | $ 69,238 |
Finite-Lived Intangible Assets, Accumulated Amortization | (66,894) | (66,801) |
Finite-Lived Intangible Assets, Foreign Currency Translation Impact | (838) | (861) |
Intellectual property, net | 1,506 | 1,576 |
Developed Technology Rights [Member] | ||
Finite-Lived Intangible Assets, Gross | 68,838 | 68,838 |
Finite-Lived Intangible Assets, Accumulated Amortization | (66,646) | (66,562) |
Finite-Lived Intangible Assets, Foreign Currency Translation Impact | (853) | (874) |
Intellectual property, net | 1,339 | 1,402 |
Technology-Based Intangible Assets [Member] | ||
Finite-Lived Intangible Assets, Gross | 400 | 400 |
Finite-Lived Intangible Assets, Accumulated Amortization | (248) | (239) |
Finite-Lived Intangible Assets, Foreign Currency Translation Impact | 15 | 13 |
Intellectual property, net | $ 167 | $ 174 |
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 | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Long-term Operating | $ 451 | $ 398 |
Short-term Operating | 0 | 0 |
Total Operating lease expense | $ 451 | $ 398 |
Note 8 - Leases -Supplemental B
Note 8 - Leases -Supplemental Balance Sheet Information (Details) | Mar. 31, 2023 | Dec. 31, 2022 |
Weighted-average remaining lease term (in years) (Year) | 6 years 8 months 12 days | 6 years 9 months 18 days |
Weighted-average discount rate | 8.40% | 8.40% |
Minimum [Member] | ||
Incremental borrowing rate | 7.07% | 6.10% |
Maximum [Member] | ||
Incremental borrowing rate | 14.50% | 14.50% |
Note 8 - Leases - Minimum Lease
Note 8 - Leases - Minimum Lease Payments (Details) $ in Thousands | Mar. 31, 2023 USD ($) |
2023 | $ 897 |
2024 | 1,142 |
2025 | 1,061 |
2026 | 847 |
2027 | 780 |
Thereafter | 2,199 |
Total minimum lease payments | 6,926 |
Less: Amount of lease payments representing interest | (1,583) |
Present value of future minimum lease payments | $ 5,343 |
Note 9 - Income Taxes (Details
Note 9 - Income Taxes (Details Textual) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2023 | |
Effective Income Tax Rate Reconciliation, Percent | (0.40%) | (0.40%) | |
Income Tax Expense (Benefit) | $ 91 | $ 84 | |
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued, Total | $ 0 | ||
Forecast [Member] | |||
Effective Income Tax Rate Reconciliation, Percent | (0.40%) |
Note 10 - Stock-based Compens_3
Note 10 - Stock-based Compensation (Details Textual) $ in Millions | 3 Months Ended |
Mar. 31, 2023 USD ($) | |
Share-Based Payment Arrangement, Option [Member] | |
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount | $ 2.9 |
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 | $ 7.4 |
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year) | 1 year 10 months 24 days |
Note 10 - Stock-based Compens_4
Note 10 - Stock-based Compensation - Stock Option Activity (Details) - $ / shares | 3 Months Ended | 12 Months Ended |
Mar. 31, 2023 | Dec. 31, 2022 | |
Options, Outstanding, Number of Shares (in shares) | 7,584,967 | |
Options, Outstanding, Weighted Average Exercise Price (in dollars per share) | $ 4.22 | |
Options, Outstanding, Weighted Average Remaining Contractual Term (Year) | 5 years 6 months 14 days | 5 years 3 months 21 days |
Options, Granted, Number of Shares (in shares) | 2,748,415 | |
Options, Grants in Period, Weighted Average Exercise Price (in dollars per share) | $ 0.73 | |
Options, Forfeited, Number of Shares (in shares) | 0 | |
Options, Forfeitures in Period, Weighted Average Exercise Price (in dollars per share) | $ 0 | |
Options, Cancelled, Number of Shares (in shares) | (913) | |
Options, Expirations in Period, Weighted Average Exercise Price (in dollars per share) | $ 4.21 | |
Options, Exercised, Number of Shares (in shares) | (13,300) | |
Options, Exercises in Period, Weighted Average Exercise Price (in dollars per share) | $ 0.38 | |
Options, Outstanding, Number of Shares (in shares) | 10,319,169 | 7,584,967 |
Options, Outstanding, Weighted Average Exercise Price (in dollars per share) | $ 3.30 | $ 4.22 |
Note 10 - Stock-based Compens_5
Note 10 - Stock-based Compensation - Stock Options Outstanding (Details) $ / shares in Units, $ in Millions | 3 Months Ended |
Mar. 31, 2023 USD ($) $ / shares shares | |
Options, Exercisable, Number of Shares (in shares) | shares | 4,843,264 |
Options, Exercisable, Weighted Average Exercise Price (in dollars per share) | $ / shares (in dollars per share) | $ / shares | $ 5.96 |
Options, Exercisable, Weighted Average Remaining Contractual Term (Year) | 4 years 9 months 18 days |
Options, Exercisable, Aggregate Intrinsic Value | $ | $ 0.4 |
Options, Vested and Expected to Vest, Exercisable, Number of Shares (in shares) | shares | 9,645,630 |
Options, Vested and Expected to Vest, Exercisable, Weighted Average Exercise Price (in dollars per share) | $ / shares | $ 3.47 |
Options, Vested and Expected to Vest, Exercisable, Weighted Average Remaining Contractual Term (Year) | 5 years 5 months 19 days |
Options, Vested or Expected to Vest, Aggregate Intrinsic Value | $ | $ 0.6 |
Note 10 - Stock-based Compens_6
Note 10 - Stock-based Compensation - Stock Option Valuation Assumptions (Details) | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Expected dividend yield | 0% | 0% |
Minimum [Member] | ||
Expected volatility | 124% | 131% |
Risk-free interest rate | 3.73% | 1.25% |
Expected life (in years) (Year) | 4 years 3 months 18 days | 4 years 3 months 18 days |
Maximum [Member] | ||
Expected volatility | 126% | 133% |
Risk-free interest rate | 4.14% | 1.94% |
Expected life (in years) (Year) | 4 years 6 months | 4 years 6 months |
Note 10 - Stock-based Compens_7
Note 10 - Stock-based Compensation - RSU Activity (Details) - Restricted Stock Units (RSUs) [Member] | 3 Months Ended |
Mar. 31, 2023 $ / shares shares | |
Beginning of period, Restricted stock units, Unvested (in shares) | shares | 8,483,491 |
Beginning of period, Restricted stock units, Unvested, weighted average grant date fair value (in dollars per share) | $ / shares | $ 1.04 |
Restricted stock units, Granted (in shares) | shares | 7,340,630 |
Restricted stock units, Granted, weighted average grant date fair value (in dollars per share) | $ / shares | $ 0.73 |
Restricted stock units, Vested (in shares) | shares | (3,082,354) |
Restricted stock units, Vested, weighted average grant date fair value (in dollars per share) | $ / shares | $ 1.18 |
Restricted stock units, Forfeited (in shares) | shares | (84,673) |
Restricted stock units, Forfeited, weighted average grant date fair value (in dollars per share) | $ / shares | $ 1.13 |
Unvested (in shares) | shares | 12,657,094 |
Unvested March 31, 2023 (in dollars per share) | $ / shares | $ 0.83 |
Note 10 - Stock-based Compens_8
Note 10 - Stock-based Compensation - Non-cash Share-based Compensation Expense (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Share-based compensation | $ 1,916 | $ 2,245 |
Share-Based Payment Arrangement, Option [Member] | ||
Share-based compensation | 665 | 978 |
Restricted Stock Units (RSUs) [Member] | ||
Share-based compensation | 859 | 883 |
Performance Restricted Stock Unit [Member] | ||
Share-based compensation | $ 392 | $ 384 |
Note 11 - Equity Offerings (Det
Note 11 - Equity Offerings (Details Textual) - The 2022 ATM Offering [Member] - USD ($) shares in Thousands, $ in Billions | 3 Months Ended | ||
Mar. 31, 2023 | Mar. 31, 2022 | Mar. 18, 2022 | |
Stock Offering Agreement, Maximum Share Value | $ 0.1 | ||
Stock Issued During Period, Shares, New Issues (in shares) | 0 | 0 |
Note 12 - Basic and Diluted N_3
Note 12 - Basic and Diluted Net Loss Per Share - Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 23,997,339 | 15,185,931 |
Share-Based Payment Arrangement, Option [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 10,319,169 | 6,766,520 |
Warrant [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 1,021,076 | 1,120,300 |
Restricted Stock Units (RSUs) [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 12,657,094 | 7,299,111 |
Note 13 - Commitments and Con_3
Note 13 - Commitments and Contingencies - Purchase Orders Commitments (Details) - License and Supply Agreement [Member] - Senhance Surgical Robotic System Acquisition[Member] $ in Thousands | Mar. 31, 2023 USD ($) |
2023 | $ 8,058 |
2024 | 439 |
2025 | 315 |
2026 | 303 |
Total commitments | $ 9,115 |
Note 14 - Segments and Geogra_3
Note 14 - Segments and Geographic Areas (Details Textual) | 3 Months Ended |
Mar. 31, 2023 | |
Number of Operating Segments | 1 |
Note 14 - Segments and Geogra_4
Note 14 - Segments and Geographic Areas - Consolidated Assets and Long Lived Assets by Geographic Area (Details) - Geographic Concentration Risk [Member] | 3 Months Ended | 12 Months Ended |
Mar. 31, 2023 | Dec. 31, 2022 | |
Long-lived Assets [Member] | UNITED STATES | ||
Percentage | 36% | 35% |
Long-lived Assets [Member] | SWITZERLAND | ||
Percentage | 45% | 46% |
Long-lived Assets [Member] | ITALY | ||
Percentage | 8% | 8% |
Long-lived Assets [Member] | Other Countries in EMEA [Member] | ||
Percentage | 8% | 8% |
Long-lived Assets [Member] | Europe, Middle East, and Africa [Member] | ||
Percentage | 61% | 62% |
Long-lived Assets [Member] | Asia [Member] | ||
Percentage | 3% | 3% |
Long-lived Assets [Member] | All Countries [Member] | ||
Percentage | 100% | 100% |
Assets, Total [Member] | UNITED STATES | ||
Percentage | 71% | 72% |
Assets, Total [Member] | SWITZERLAND | ||
Percentage | 24% | 24% |
Assets, Total [Member] | ITALY | ||
Percentage | 2% | 2% |
Assets, Total [Member] | Other Countries in EMEA [Member] | ||
Percentage | 2% | 1% |
Assets, Total [Member] | Europe, Middle East, and Africa [Member] | ||
Percentage | 28% | 27% |
Assets, Total [Member] | Asia [Member] | ||
Percentage | 1% | 1% |
Assets, Total [Member] | All Countries [Member] | ||
Percentage | 100% | 100% |
Note 14 - Segments and Geogra_5
Note 14 - Segments and Geographic Areas - Sales by Geographic Area (Details) - Revenue Benchmark [Member] - Geographic Concentration Risk [Member] | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
UNITED STATES | ||
Concentration risk, percent | 21% | 24% |
EMEA [Member] | ||
Concentration risk, percent | 58% | 48% |
Asia [Member] | ||
Concentration risk, percent | 21% | 28% |
All Countries [Member] | ||
Concentration risk, percent | 100% | 100% |
Note 15 - Related Party Trans_2
Note 15 - Related Party Transactions (Details Textual) - USD ($) | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Asensus Surgical Europe S.à.R.L [Member] | 1 Med S.A. [Member] | Service Supply Agreement [Member] | ||
Administrative Fees Expense | $ 19,000 | $ 73,000 |