Asensus Surgical (TRXDW) 10-Q 11 May 23 2023 Q1 Quarterly report Financial data

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