Document And Entity Information
Document And Entity Information - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2023 | May 15, 2024 | Jun. 30, 2023 | |
Document Information [Line Items] | |||
Document Type | 10-K | ||
Document Annual Report | true | ||
Document Period End Date | Dec. 31, 2023 | ||
Document Transition Report | false | ||
Entity File Number | 0-19437 | ||
Entity Registrant Name | ASENSUS SURGICAL, INC. | ||
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 | ||
Title of 12(b) Security | Common Stock | ||
Trading Symbol | ASXC | ||
Security Exchange Name | NYSE | ||
Entity Well-known Seasoned Issuer | No | ||
Entity Voluntary Filers | No | ||
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 | ||
ICFR Auditor Attestation Flag | false | ||
Document Financial Statement Error Correction [Flag] | false | ||
Entity Shell Company | false | ||
Entity Public Float | $ 120.1 | ||
Entity Common Stock, Shares Outstanding (in shares) | 271,986,369 | ||
Auditor Firm ID | 243 | ||
Auditor Name | BDO USA, P.C. | ||
Auditor Location | Raleigh, North Carolina | ||
Entity Central Index Key | 0000876378 | ||
Current Fiscal Year End Date | --12-31 | ||
Document Fiscal Year Focus | 2023 | ||
Document Fiscal Period Focus | FY | ||
Amendment Flag | false |
Consolidated Balance Sheets
Consolidated Balance Sheets - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Current Assets: | ||
Cash and cash equivalents | $ 17,096 | $ 6,329 |
Short-term investments, available-for-sale | 3,971 | 64,195 |
Accounts receivable, net | 3,508 | 2,256 |
Inventories | 7,172 | 8,284 |
Prepaid expenses | 3,143 | 3,584 |
Employee retention tax credit receivable | 0 | 554 |
Other current assets | 1,496 | 1,671 |
Total Current Assets | 36,386 | 86,873 |
Restricted cash | 1,642 | 1,141 |
Long-term investments, available-for-sale | 0 | 3,865 |
Inventories, net of current portion | 4,043 | 5,469 |
Property and equipment, net | 8,959 | 9,542 |
Intellectual property, net | 1,237 | 1,576 |
Net deferred tax assets | 44 | 174 |
Operating lease right-of-use assets, net | 5,165 | 4,950 |
Other long-term assets | 1,610 | 2,463 |
Total Assets | 59,086 | 116,053 |
Current Liabilities: | ||
Accounts payable | 4,145 | 3,348 |
Accrued employee compensation and benefits | 5,390 | 4,508 |
Accrued expenses and other current liabilities | 1,636 | 1,293 |
Operating lease liabilities - current portion | 1,036 | 800 |
Deferred revenue | 421 | 465 |
Total Current Liabilities | 12,628 | 10,414 |
Long-Term Liabilities: | ||
Deferred revenue - less current portion | 290 | 0 |
Contingent consideration | 2,220 | 1,256 |
Warrant liabilities | 5,888 | 0 |
Noncurrent operating lease liabilities | 4,646 | 4,738 |
Total Liabilities | 25,672 | 16,408 |
Stockholders' Equity: | ||
Common stock $0.001 par value, 750,000,000 shares authorized at December 31, 2023 and December 31, 2022; 264,921,526 and 236,895,440 shares issued and outstanding at December 31, 2023 and December 31, 2022, respectively | 265 | 237 |
Preferred stock, $0.01 par value, 25,000,000 shares authorized, no shares issued and outstanding at December 31, 2023 and December 31, 2022 | 0 | 0 |
Additional paid-in capital | 973,129 | 962,731 |
Accumulated deficit | (939,368) | (860,935) |
Accumulated other comprehensive loss | (612) | (2,388) |
Total Stockholders' Equity | 33,414 | 99,645 |
Total Liabilities and Stockholders' Equity | 59,086 | 116,053 |
Intellectual Property [Member] | ||
Current Assets: | ||
Intellectual property, net | $ 1,237 | $ 1,576 |
Consolidated Balance Sheets (Pa
Consolidated Balance Sheets (Parentheticals) - $ / shares | Dec. 31, 2023 | Dec. 31, 2022 |
Common Stock, Par or Stated Value Per Share (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) | 264,921,526 | 236,895,440 |
Common Stock, Shares, Outstanding (in shares) | 264,921,526 | 236,895,440 |
Preferred Stock, Par or Stated Value Per Share (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 |
Consolidated Statements of Oper
Consolidated Statements of Operations and Comprehensive Loss - USD ($) shares in Thousands, $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Revenue: | ||
Revenue | $ 8,577 | $ 7,087 |
Cost of revenue: | ||
Cost of revenue | 13,155 | 10,872 |
Gross loss | (4,578) | (3,785) |
Operating Expenses: | ||
Research and development | 37,023 | 28,942 |
Sales and marketing | 16,921 | 14,756 |
General and administrative | 19,155 | 20,172 |
Amortization of intangible assets | 453 | 7,708 |
Change in fair value of contingent consideration | 964 | (1,115) |
Impairment of property and equipment | 374 | 1,431 |
Total operating expenses | 74,890 | 71,894 |
Operating loss | (79,468) | (75,679) |
Other Income (Expense), net | ||
Change in fair value of warrant liabilities | 1,232 | 0 |
Interest income | 1,553 | 1,141 |
Interest expense | 0 | (410) |
Other expense, net | (1,436) | (295) |
Total other income (expense), net | 1,349 | 436 |
Loss before income taxes | (78,119) | (75,243) |
Income tax expense | (314) | (318) |
Net loss | $ (78,433) | $ (75,561) |
Net loss per common share attributable to common stockholders - basic and diluted (in dollars per share) | $ (0.31) | $ (0.32) |
Weighted average number of shares used in computing net loss per common share - basic and diluted (in shares) | 249,685 | 236,492 |
Comprehensive loss: | ||
Net loss | $ (78,433) | $ (75,561) |
Foreign currency translation gain (loss) | 1,280 | (1,867) |
Unrealized gain (loss) on available-for-sale investments | 496 | (257) |
Comprehensive loss | (76,657) | (77,685) |
Product [Member] | ||
Revenue: | ||
Revenue | 5,519 | 4,327 |
Cost of revenue: | ||
Cost of revenue | 6,866 | 5,303 |
Service [Member] | ||
Revenue: | ||
Revenue | 1,052 | 1,373 |
Cost of revenue: | ||
Cost of revenue | 2,293 | 2,174 |
Lease [Member] | ||
Revenue: | ||
Revenue | 2,006 | 1,387 |
Cost of revenue: | ||
Cost of revenue | $ 3,996 | $ 3,395 |
Consolidated Statements of Chan
Consolidated Statements of Changes in Stockholders' Equity - 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 | 8,416 | 0 | 0 | 8,416 | |
Exercise of stock options (in shares) | 43,000 | 0 | ||||
Exercise of stock options | $ 0 | $ 0 | 18 | 0 | 0 | 18 |
Issuance of common stock related to vesting of restricted stock units (in shares) | 1,633,000 | 0 | ||||
Issuance of common stock related to vesting of restricted stock units | $ 2 | $ 0 | 0 | 0 | 0 | 2 |
Shares withheld related to net share settlement of equity awards (in shares) | 0 | 443,000 | ||||
Shares withheld related to net share settlement of equity awards | $ 0 | $ 0 | (352) | 0 | 0 | (352) |
Cancellation of treasury stock (in shares) | 0 | (443,000) | ||||
Cancellation of treasury stock | $ 0 | $ 0 | 0 | 0 | 0 | 0 |
Other comprehensive income (loss) | 0 | 0 | 0 | 0 | (2,124) | (2,124) |
Net loss | 0 | 0 | (75,561) | 0 | (75,561) | |
Cancellation of treasury stock | $ 0 | $ 0 | 0 | 0 | 0 | 0 |
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 | 7,918 | 0 | 0 | $ 7,918 | |
Exercise of stock options (in shares) | 13,000 | 0 | 13,300 | |||
Exercise of stock options | $ 0 | $ 0 | 5 | 0 | 0 | $ 5 |
Issuance of common stock related to vesting of restricted stock units (in shares) | 3,270,000 | 0 | ||||
Issuance of common stock related to vesting of restricted stock units | $ 2 | $ 0 | 0 | 0 | 0 | 2 |
Shares withheld related to net share settlement of equity awards (in shares) | 0 | 657,000 | ||||
Shares withheld related to net share settlement of equity awards | $ 0 | $ 1 | (497) | 0 | 0 | (496) |
Cancellation of treasury stock (in shares) | 0 | (657,000) | ||||
Cancellation of treasury stock | $ 0 | $ 1 | 0 | 0 | 0 | (1) |
Other comprehensive income (loss) | 0 | 0 | 1,776 | 1,776 | ||
Net loss | 0 | (78,433) | 0 | (78,433) | ||
Cancellation of treasury stock | $ 0 | $ (1) | 0 | 0 | 0 | 1 |
Issuance of common stock, net of issuance costs (in shares) | 24,744,000 | 0 | ||||
Issuance of common stock, net of issuance costs | $ 26 | 0 | 0 | 2,998 | ||
Balance (in shares) at Dec. 31, 2023 | 264,922,000 | 0 | ||||
Balance at Dec. 31, 2023 | $ 265 | $ 0 | $ 973,129 | $ (939,368) | $ (612) | $ 33,414 |
Consolidated Statements of Cash
Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Operating Activities: | ||
Net loss | $ (78,433) | $ (75,561) |
Adjustments to reconcile net loss to net cash and cash equivalents used in operating activities: | ||
Depreciation | 3,276 | 3,368 |
Amortization of intangible assets | 453 | 7,708 |
Amortization of discounts and premiums on investments, net | (482) | 565 |
Stock-based compensation | 7,918 | 8,416 |
Deferred tax expense | 132 | 318 |
Change in inventory reserves | 324 | 620 |
Bad debt expense | 0 | 9 |
Impairment of property and equipment | 374 | 1,431 |
Loss on disposal of property and equipment | 0 | 122 |
Change in fair value of warrant liabilities | (1,232) | 0 |
Change in fair value of contingent consideration | 964 | (1,115) |
Changes in operating assets and liabilities: | ||
Accounts receivable | (1,178) | (1,528) |
Inventories | 129 | (2,302) |
Operating lease right-of-use assets | (206) | 232 |
Prepaid expenses | 424 | (450) |
Employee retention tax credit receivable | 554 | 757 |
Other current and long-term assets | 1,173 | (2,101) |
Accounts payable | 574 | 35 |
Accrued employee compensation and benefits | 881 | 4,523 |
Accrued expenses | 365 | (3,955) |
Deferred revenue | 233 | (55) |
Operating lease liabilities | 130 | 26 |
Net cash and cash equivalents used in operating activities | (63,627) | (58,937) |
Investing Activities: | ||
Purchase of available-for-sale investments | (12,268) | (33,886) |
Proceeds from maturities of available-for-sale investments | 77,335 | 82,702 |
Purchase of property and equipment | (561) | (1,279) |
Net cash and cash equivalents provided by (used in) investing activities | 64,506 | 47,537 |
Financing Activities: | ||
Proceeds from issuance of common stock, net of issuance costs | 10,118 | 0 |
Taxes paid related to net share settlement of vesting of restricted stock units | (497) | (350) |
Proceeds from exercise of stock options and warrants | 5 | 18 |
Net cash and cash equivalents (used in) provided by financing activities | 9,626 | (332) |
Effect of exchange rate changes on cash and cash equivalents | 763 | (81) |
Net (decrease) increase in cash, cash equivalents and restricted cash | 11,268 | (11,813) |
Cash, cash equivalents and restricted cash, beginning of period | 7,470 | 19,283 |
Cash, cash equivalents and restricted cash, end of period | 18,738 | 7,470 |
Supplemental Disclosure for Cash Flow Information | ||
Cash paid for leases | 1,475 | 984 |
Cash paid for taxes | 352 | 165 |
Supplemental Schedule of Non-cash Investing and Financing Activities: | ||
Transfer of inventories to property and equipment | 2,941 | 2,693 |
Lease liabilities arising from obtaining right-of-use assets | $ 1,143 | $ 577 |
Note 1 - Description of the Bus
Note 1 - Description of the Business | 12 Months Ended |
Dec. 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 Performance-Guided Surgery™ by unlocking clinical intelligence for surgeons to enable consistently superior outcomes and a new standard of surgery. The Company is focused on the market development for and commercialization of the Senhance® Surgical System, which digitizes laparoscopic minimally invasive surgery, or MIS. The Senhance System is the first and only digital, multi-port laparoscopic platform designed to maintain laparoscopic MIS standards while providing digital benefits such as haptic feedback, robotic precision, comfortable ergonomics, advanced instrumentation including 3mm micro-laparoscopic instruments, 5mm articulating instruments, eye-sensing camera control and fully-reusable standard instruments to help maintain per-procedure costs similar to traditional laparoscopy. |
Note 2 - Summary of Significant
Note 2 - Summary of Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Significant Accounting Policies [Text Block] | Summary of Significant Accounting Policies Basis of Presentation The accompanying 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. Going Concern The Company's 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 $939.4 million and working capital of $23.8 million as of December 31, 2023. The Company has not established sufficient sales revenues to cover its operating costs and requires additional capital to proceed with its operating plan. The ability of the Company to continue as a going concern is dependent on the Company obtaining adequate capital to fund operating losses until it becomes profitable. 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 include additional sales of equity, traditional financing, such as loans, entry into a strategic collaboration, entry into an out-licensing arrangement or provision of additional distribution rights in some or all of our markets. However, management cannot provide any assurance that the Company will be successful in accomplishing any or all of its plans. The ability to successfully resolve these factors raise substantial doubt about the Company’s ability to meet its existing obligations, and to continue as a going concern within one year from the date that these financial statements are issued. The consolidated financial statements of the Company do not include any adjustments that may result from the outcome of these aforementioned uncertainties. Principles of Consolidation and Foreign Currency Considerations The accompanying consolidated financial statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., Asensus International, Inc., Asensus Surgical Italia S.r.l., Asensus Surgical Europe S.à r.l., Asensus Surgical Taiwan Ltd., Asensus Surgical Japan K.K., Asensus Surgical Israel Ltd., Asensus Surgical Netherlands B.V., and Asensus Surgical Canada, Inc. All inter-company accounts and transactions have been eliminated in consolidation. The functional currency of the Company’s operational foreign subsidiaries is predominantly the Euro. The assets and liabilities of the Company’s foreign subsidiaries are translated into U.S. dollars at exchange rates in effect at the balance sheet date. Income and expense items are translated at the average exchange rates prevailing during the period. The cumulative translation effect for a subsidiary using a functional currency other than the U.S. dollar is included in accumulated other comprehensive loss as a separate component of stockholders’ equity which was $0.6 million and $1.9 million as of December 31, 2023 and 2022, respectively. The Company’s intercompany accounts are denominated in the functional currency of the foreign subsidiary. Gains and losses resulting from the remeasurement of intercompany receivables that the Company considers to be of a long-term investment nature are recorded as a cumulative translation adjustment in accumulated other comprehensive loss as a separate component of stockholders’ equity, while gains and losses resulting from the remeasurement of intercompany receivables from a foreign subsidiary for which the Company anticipates settlement in the foreseeable future are recorded in the consolidated statements of operations and comprehensive loss. The net gains and losses included in net loss in the consolidated statements of operations and comprehensive loss for the years ended December 31, 2023 and 2022 were not material. 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, obtain regulatory clearance for and commercialize its products and products in development; negative impacts on the Company's operations caused by the hostilities in the Middle East and other geopolitical factors; the success of its market development efforts; the timing and outcome of the regulatory review process for its products; changes in the healthcare regulatory environments of the United States, the European Union, Japan, Taiwan and other countries in which the Company operates or intends to operate; its ability to attract and retain key management, marketing and scientific personnel; its ability to successfully prepare, file, prosecute, maintain, defend and enforce patent claims and other intellectual property rights; its ability to successfully transition from a research and development company to a marketing, sales and distribution company; competition in the market for robotic and digital surgical devices; and its ability to identify and pursue development of additional products. 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 investments, changes in 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. Cash and Cash Equivalents, Restricted Cash, and Investments The Company considers all highly liquid investments with original maturities of 90 days or less at the time of purchase to be cash equivalents. Restricted cash as of December 31, 2023 and 2022 includes $1.6 million and $1.1 million, respectively, in cash accounts held as collateral primarily under the terms of office operating leases, credit cards, and automobile leases, and a guarantee required by the government of a country for a 2019 VAT refund. The Company’s investments as of December 31, 2023 consisted of corporate bonds that were classified as available-for-sale. Investments classified as available-for-sale are measured at fair value, and net unrealized gains and losses are recorded as a component of accumulated other comprehensive loss on the consolidated balance sheets until realized. The amortized cost of debt securities is adjusted for amortization of premiums and accretion of discounts to maturity computed under the effective interest method. Such amortization and accretion are included in interest expense, net. There were no Investments with remaining maturities at date of purchase greater than 90 days and remaining maturities as of the reporting period less than one year are classified as short-term investments. Investments with remaining maturities greater than one year are classified as long-term investments. There have been no no Fair Value Measurements The Company measures the fair value of money market funds, certain U.S. treasury securities, and equity investments with readily determinable value based on quoted prices in active markets for identical assets as Level 1 securities. Marketable securities measured at fair value using Level 2 inputs are primarily comprised of commercial paper and corporate notes and bonds without readily determinable value. The Company reviews trading activity and pricing for these investments as of the measurement date. When sufficient quoted pricing for identical securities is not available, the Company uses market pricing and other observable market inputs for similar securities obtained from various third-party data providers. These inputs either represent quoted prices for similar assets in active markets or have been derived from observable market data. This approach results in the Level 2 classification of these securities within the fair value hierarchy. The Company measures contingent consideration at fair value using a Monte-Carlo simulation utilizing Level 3 inputs. These inputs include the probability of achieving each of the potential milestones, revenue volatility, and an estimated discount rate associated with the risks of the expected cash flows attributable to the achievement of various milestones. Concentrations and Credit Risk The Company’s principal financial instruments subject to potential concentration of credit risk are cash and cash equivalents (including restricted cash), and investments, including amounts held in money market funds, commercial paper, and corporate bonds. The Company places cash deposits with a federally insured financial institution. The Company maintains its cash at banks and financial institutions it considers to be of high credit quality; however, the Company’s domestic cash deposits may at times exceed the Federal Deposit Insurance Corporation’s insured limit. Balances in excess of federally insured limitations may not be insured. The Company has not experienced losses on these accounts, and management believes that the Company is not exposed to significant risks on such accounts. Investments are stated at their estimated fair values, based on quoted market prices for the same or similar instruments. The counterparties to the agreements relating to the Company’s investments consist of various major corporations, financial institutions, and government agencies of high credit standing. The Company’s accounts receivable are derived from sales and leases to customers located throughout the world. The Company evaluates its customers’ financial condition and, generally, requires no collateral from its customers. The Company had one two one 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 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 and future economic conditions that may affect a customer’s ability to pay. The allowance for expected credit losses was $1.6 million as of December 31, 2023 and 2022. Inventories Inventories are stated at the lower of cost (determined on a first-in, first-out basis) or net realizable value. Inventory costs include direct materials, direct labor, and normal manufacturing overhead. The Company records reserves, when necessary, to reduce the carrying value of inventory to its net realizable value. Management considers historical consumption and forecast demand in relation to the inventory on hand, competitiveness of product offerings, market conditions and product life cycles when determining excess and obsolescence and net realizable value adjustments. At the point of loss recognition, a new, lower-cost basis for that inventory is established, and any subsequent improvements in facts and circumstances do not result in the restoration or increase in that newly established cost basis. Any inventory on hand at the measurement date in excess of the Company's current requirements based on anticipated levels of sales is classified as long-term on the Company's consolidated balance sheets. The Company's classification of long-term inventory requires it to estimate the portion of on hand inventory that can be realized over the upcoming twelve months. Definite-Lived Intangible Assets - Intellectual Property Intellectual property consists of purchased patent rights and developed technology acquired as part of a business acquisition. Developed technology includes reclassified in-process research and development (“IPR&D”) assets related to (i) the Senhance System acquired in 2015 and reclassified in 2017 and (ii) a 2018 acquisition and reclassified in 2020. Amortization of the patent rights is recorded using the straight-line method over the estimated useful life of the patents of 10 years. Amortization of the developed technology is recorded using the straight-line method over the estimated useful life of 7 years. The Company periodically evaluates intellectual property for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. To determine the recoverability, the Company evaluates the probability that future estimated undiscounted net cash flows will be less than the carrying amount of the assets. If such estimated cash flows are less than the carrying amount of the assets, then such assets are written down to their fair value. No Property and Equipment Property and equipment consists primarily of operating lease Senhance System assets, machinery, manufacturing equipment, demonstration equipment, computer equipment, furniture, and leasehold improvements, which are recorded at cost less accumulated depreciation. Depreciation is recorded using the straight-line method over the estimated useful lives of the assets as follows: Years Operating lease assets – Senhance System leasing 5 Machinery, manufacturing, and demonstration equipment 3 - 5 Computer equipment 3 Furniture 5 Leasehold improvements Lesser of lease term or 3-10 The Company reviews its property and equipment assets for possible impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not be fully recoverable. To determine the recoverability of its long-lived assets, the Company evaluates the probability that future estimated undiscounted net cash flows will be less than the carrying amount of the assets. If such estimated cash flows are less than the carrying amount of the long-lived assets, then such assets are written down to their fair value. During the years ended December 31, 2023 and 2022, the Company recorded a non-cash asset impairment charge of $0.4 million and $1.4 million, respectively, to reduce the carrying value of property and equipment to its estimated fair value. The property and equipment impairment is associated with returned Senhance Systems under operating leases and Senhance Systems currently under operating leases that are not expected to generate future cash flows sufficient to recover their net book value. The fair value was estimated based on the discounted cash flows expected to be produced by the property and equipment. The impairment was recorded in property and equipment impairment on the consolidated statements of operations and comprehensive loss. Operating Leases The Company has operating leases for its corporate office buildings, vehicles, and machinery and equipment. At inception, the Company determines whether an agreement represents a lease, and at commencement, it evaluates each lease agreement to determine whether the lease constitutes an operating or financing lease. The Company accounts for lease components and non-lease components as a single component. Non-lease components consist of common area maintenance payments for most real estate leases, which are determined based on costs incurred by the lessor. Many of the Company’s leases include base rental periods coupled with options to renew or terminate the lease, generally at the Company’s discretion. In evaluating the lease term, the Company considers whether renewal is reasonably certain. To the extent a significant economic incentive exists to renew the lease, the option is included within the lease term. Based on the Company’s leases, renewal options generally do not provide a significant economic incentive and are therefore excluded from the lease term. While its operating leases range from one ten one six The interest rate implicit in lease contracts is typically not readily determinable. As such, the Company utilizes the appropriate incremental borrowing rate, which is the rate incurred to borrow on a collateralized basis over a similar term an amount equal to the lease payments in a similar economic environment. Operating lease expense is recognized on a straight-line basis over the lease term, subject to any changes in the lease or expectations regarding the terms. Implementation Costs in a Cloud Computing Arrangement The Company capitalizes qualified implementation costs incurred in a hosting arrangement that is a service contract. These capitalized implementation costs are recorded within other current and long-term assets, and are generally amortized over the fixed, non-cancellable term of the associated hosting arrangement on a straight-line basis and included within operating expenses. Employee Retention Tax Credit Receivable The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) included an Employee Retention Tax Credit (“ERTC”) provision designed to encourage employers to keep employees on their payroll. The ERTC is a refundable tax credit against certain payroll taxes paid by employers for eligible wages. During the year ended December 31, 2021, the Company submitted an ERTC refund for $1.3 million and recorded the amount into Other Income (Expense) on the consolidated statements of operations and comprehensive loss. The Company received $0.7 million of the ERTC refund during the year ended December 31, 2022 and received the remaining $0.6 million during the year ended December 31, 2023. Contingent Consideration Contingent consideration is recorded as a liability and is the estimate of the fair value of potential milestone payments related to business acquisitions. Contingent consideration is measured at fair value using a Monte-Carlo simulation utilizing significant unobservable inputs including the probability of achieving each of the potential milestones, future Euro-to-USD exchange rates, revenue volatility and an estimated discount rate associated with the risks of the expected cash flows attributable to the various milestones. Significant increases or decreases in any of the probabilities of success or changes in expected achievement of any of these milestones would result in a significantly higher or lower fair value of these milestones, respectively, and commensurate changes to the associated liability. The contingent consideration is revalued at each reporting period and changes in fair value are recognized in the consolidated statements of operations and comprehensive loss. On September 21, 2015, the Company completed the strategic acquisition, through its wholly owned subsidiary TransEnterix International, from Sofar S.p.A., an Italian company (“Sofar”), an Italian company, of all of the assets, employees and contracts related to the advanced robotic system for minimally invasive laparoscopic surgery now known as the Senhance System. Under the terms of the Purchase Agreement, as amended in 2016, as of December 31, 2023, the Company has accrued $2.2 million of estimated fair value of remaining contingent consideration related to a milestone of €15.0 €25.0 Warrant Liabilities The Company’s warrants (see “Note 14 – Equity Offerings,”) are measured at fair value using a Black-Scholes-Merton model option-pricing model which takes into account, as of the valuation date, factors including the current exercise price, the expected life of the warrant, the current price of the underlying stock, its expected stock price volatility, the expected dividend yield which is assumed to be zero since The Company has not paid and does not anticipate paying cash dividends on its shares of common stock and the risk-free interest rate is based on U.S. Treasury rates whose term is consistent with the term of the warrant (see “Note 6 – Fair Value,”). The warrant liability is revalued at each reporting period and changes in fair value are recognized in the consolidated statements of operations and comprehensive loss. Revenue Recognition The Company’s revenue consists of product revenue resulting from the sale of Senhance Systems, Senhance System components, and instruments and accessories. Service revenue consists of revenue related to Senhance System service agreements. Lease revenue consists of revenue generated from utilizing the Senhance System, instruments and accessories, and servicing of the Senhance System under operating lease agreements. The Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and the customer, the rights of the parties are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company's revenues are measured based on considerations specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government authorities. The Company’s Senhance System sale arrangements could include a five four The Company’s Senhance System sale arrangements generally contain multiple products and services. For these consolidated sale arrangements, the Company accounts for individual products and services as separate performance obligations if they are distinct, which is if a product or service is separately identifiable from other items in the consolidated package, and if a customer can benefit from it on its own or with other resources that are readily available to the customer. The Company’s Senhance System sale arrangements may include a combination of the following performance obligations: system(s), system components, instruments, accessories, and system services. For arrangements that contain multiple performance obligations, revenue is allocated to each performance obligation based on its relative estimated standalone selling price. When available, standalone selling prices are based on observable prices at which the Company separately sells the products or services. The Company recognizes revenues when or as the performance obligations are satisfied by transferring control of the product or service to a customer. The Company generally recognizes revenue for the performance obligations as follows: ● System sales. For Senhance Systems and Senhance System components sold directly to end customers (including those arising from Senhance System purchases under lease rights to purchase), revenue is recognized when the Company transfers control to the customer, which is generally at the point when acceptance occurs that indicates customer acknowledgment of delivery or installation, depending on the terms of the arrangement. For lease buyouts, where the customer has already acknowledged installation of the system, transfer of control occurs when the Company receives an executed contract for the lease buyout of the Senhance System. For Senhance Systems sold through distributors, for which distributors are responsible for installation, revenue is recognized generally upon delivery. The Company’s Senhance System arrangements generally do not provide a right of return. The Senhance Systems are generally covered by a one-year warranty. Warranty costs were not material for the periods presented. ● Instruments and accessories. Revenue from sales of instruments and accessories is recognized when control is transferred to the customers, which generally occurs at the time of shipment, but also occurs at the time of delivery depending on the customer arrangement. ● Service. Service revenue is recognized ratably over the term of the service period as the customers benefit from the service throughout the service period. Revenue related to services performed on a time-and-materials basis is recognized when performed. The Company invoices its customers based on the billing schedules in its sales arrangements. Payments are generally due 30 to 60 days from the date of invoice. Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative selling price of the related performance obligations and the contractual billing terms in the arrangements and are included in accounts receivable. In connection with assets recognized from the costs to obtain a contract with a customer, the Company determined that the sales incentive programs for its sales team do not meet the requirements to be capitalized as the Company does not expect to generate future economic benefits from the related revenue from the initial sales transaction and such costs are expensed as incurred. 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 years ended December 31, 2023 and 2022, variable lease revenue related to usage-based arrangements was not material. In determining whether a transaction should be classified as a sales-type, operating, or direct financing lease, the Company considers the following terms at lease commencement: (1) whether title of the Senhance System transfers automatically or for a nominal fee by the end of the lease term, (2) whether the present value of the minimum lease payments equals or exceeds substantially all of the fair value of the leased Senhance System, (3) whether the lease term is for the major part of the remaining economic life of the leased System, (4) whether the lease grants the lessee an option to purchase the leased Senhance System that the lessee is reasonably certain to exercise, and (5) whether the underlying Senhance System is of such a specialized nature that it is expected to have no alternative use to the Company at the end of the lease term. All such arrangements through December 31, 2023 are classified as operating leases. Revenue related to lease elements from operating lease arrangements is generally recognized on a straight-line basis over the lease term or based upon Senhance System usage. As of December 31, 2023, future minimum lease payments due from customers was $2.2 million, which is expected to be received over the next one to two years. Cost of Revenue Cost of revenue consists of contract manufacturing, materials, labor and manufacturing overhead incurred internally to produce the products. Depreciation expense related to leased systems is included in the cost of revenue. Shipping and handling costs incurred by the Company are included in the cost of revenue. We expense all inventory obsolescence provisions as cost of revenue. Research and Development Costs Research and development expenses primarily consist of engineering, product development and regulatory expenses, incurred in the design, development, testing and enhancement of our products. Research and development costs are expensed as incurred. Stock-Based Compensation The Company recognizes expenses for share-based awards exchanged for services rendered equal to the estimated fair value of these awards over the requisite service period. The Company recognizes as expense, the grant-date fair value of stock options and other stock-based compensation issued to employees and non-employee directors over the requisite service periods, which are typically the vesting periods. The Company uses the Black-Scholes-Merton model to estimate the fair value of stock options. The volatility assumption used in the Black-Scholes-Merton model is based on the Company’s historical volatility. The expected term of options granted has been determined based upon the simplified method, because the Company does not have sufficient historical information regarding its options to derive the expected term. Under this approach, the expected term is the mid-point between the weighted average of vesting period and the contractual term. The risk-free interest rate is based on U.S. Treasury rates whose term is consistent with the expected life of the stock options. The Company has not paid and does not anticipate paying cash dividends on its shares of common stock; therefore, the expected dividend yield is assumed to be zero The fair value of restricted stock units is determined by the market price of the Company’s common stock on the date of grant. See “Note 13 – Stock-Based Compensation,” for a detailed discussion of the Company’s stock plans and stock-based compensation expense. Income Taxes The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets or liabilities for the temporary differences between financial reporting and tax basis of the Company’s assets and liabilities, and for tax carryforwards at enacted statutory rates in effect for the years in which the asset or liability is expected to be realized. The effect on deferred taxes of a change in tax rates is recognized in income during the period that includes the enactment date. In addition, valuation allowances are established when necessary to reduce deferred tax assets and liabilities to the amounts expected to be realized. The Company has elected to account for global intangible low-taxed income (“GILTI”) as a period expense in the year the tax is incurred. The Company recognizes the financial statement benefit of an income tax position only after determining that the relevant taxing authority would more likely than not sustain the position following audit. For tax positions meeting the more likely than not threshold, the amount recognized in the financial statements is the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement with the relevant taxing authority. The Company recognizes interest accrued related to unrecognized tax benefits and penalties in the provision for income taxes. Tax regulations within each jurisdiction are subject to the interpretation of the related tax laws and regulations and require application of significant judgment. The Company is subject to U.S. federal and various state, local and foreign jurisdictions. Due to the Company’s net operating loss carryforwards, the Company may be subject to examination by authorities for all previously filed income tax returns. Comprehensive Loss Comprehensive loss is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Segments The Company operates in one Impact of Recently Issued Accounting Standards In November 2023, the FASB issued Accounting Standards Update, or ASU, No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures The ASU is to be applied retrospectively to all prior periods presented in the financial statements with an effective date for all public entities for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted. The Company is currently evaluating the impact of this ASU. In December 2023, the FASB issues ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures This ASU is to be applied on a prospective basis with an effective date for all public entities for annual periods beginning after December 15, 2024. Early adoption is permitted. The Company is currently evaluating the impact of this ASU. |
Note 3 - Revenue Recognition
Note 3 - Revenue Recognition | 12 Months Ended |
Dec. 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: Years Ended December 31, 2023 2022 (in thousands) U.S. Instruments and accessories $ 205 $ 211 Services 294 300 Leases 196 256 Total U.S. revenue 695 767 Outside of U.S. ("OUS") Systems 3,645 2,551 Instruments and accessories 1,669 1,565 Services 758 1,073 Leases 1,810 1,131 Total OUS revenue 7,882 6,320 Total Systems 3,645 2,551 Instruments and accessories 1,874 1,776 Services 1,052 1,373 Leases 2,006 1,387 Total revenue $ 8,577 $ 7,087 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 yet been recognized. A significant portion of this amount relates to service obligations performed under the Company's system sales contracts that will be invoiced and recognized as revenue in future periods. Transaction price allocated to remaining performance obligations as of December 31, 2023 was $0.9 million, which is expected to be recognized over 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 have any significant impairment losses on its contract assets for the periods presented. Revenue recognized for the years ended December 31, 2023 and 2022 was $0.5 million, which was included in the deferred revenue balance of $0.5 million as of December 31, 2022 and 2021. The following information summarizes the Company’s contract assets and liabilities: December 31, 2023 December 31, 2022 (in thousands) Contract assets $ 95 $ 116 Deferred revenue $ 711 $ 465 |
Note 4 - Cash, Cash Equivalents
Note 4 - Cash, Cash Equivalents, and Restricted Cash | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Cash, Cash Equivalents, and Restricted Cash Disclosure [Text Block] | 4. Cash, Cash Equivalents, and Restricted Cash Cash, cash equivalents and restricted cash consist of the following: December 31, December 31, 2023 2022 (in thousands) Cash $ 4,588 $ 3,473 Money market 5,521 2,856 U.S. treasuries 6,987 - Total cash and cash equivalents $ 17,096 $ 6,329 Restricted cash 1,642 1,141 Total $ 18,738 $ 7,470 Restricted cash at December 31, 2023 and 2022 includes $1.6 million and $1.1 million, respectively, in cash accounts held as collateral primarily under the terms of an office operating lease, credit cards, automobile leases, and a guarantee required by the government of a country for a 2019 VAT refund. |
Note 5 - Investments, Available
Note 5 - Investments, Available-for-sale | 12 Months Ended |
Dec. 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: December 31, 2023 Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments (in thousands) Corporate bonds $ 3,981 $ - $ (10 ) $ 3,971 $ 3,971 Total investments $ 3,981 $ - $ (10 ) $ 3,971 $ 3,971 December 31, 2022 Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments (in thousands) 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: December 31, 2023 Amortized Cost Fair Value (in thousands) Mature in less than one year $ 3,981 $ 3,971 Total $ 3,981 $ 3,971 Actual maturities may differ from contractual maturities because certain borrowers have the right to call or prepay certain obligations. There were no no |
Note 6 - Fair Value
Note 6 - Fair Value | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Fair Value Disclosures [Text Block] | 6. 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); significant other observable inputs (Level 2); and significant unobservable inputs (Level 3): December 31, 2023 Quoted Prices Markets for Significant Significant Total Description (in thousands) Assets measured at fair value Cash and cash equivalents (1) $ 17,096 $ - $ - $ 17,096 Restricted cash 1,642 - - 1,642 Short-term investments - 3,971 - 3,971 Total assets measured at fair value $ 18,738 $ 3,971 $ - $ 22,709 Liabilities measured at fair value Contingent consideration $ - $ - $ 2,220 $ 2,220 Warrant Liabilities - - 5,888 5,888 Total liabilities measured at fair value $ - $ - $ 8,108 $ 8,108 December 31, 2022 Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Description (in thousands) 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) 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, deferred revenue, and other current liabilities as of December 31, 2023 and December 31, 2022, approximate to their fair values due to the short-term nature of these items and are considered to be Level 1. The Company’s financial liabilities consisted of contingent consideration payable to Three Heads Investment S.r.l., related to the Company’s 2015 acquisition of the Senhance Surgical System from an assignor to Three Heads Investment S.r.l. (the “Senhance Acquisition”). Adjustments associated with the change in fair value of contingent consideration are included in the Company’s consolidated statements of operations and comprehensive loss. 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 December 31, 2023 and December 31, 2022: Valuation Significant Input December 31, December 31, Contingent consideration Probability Milestone dates 2032 2032 Discount rate 10.0 % 16.5 % Revenue volatility 35.0 % 45.0 % EUR-to-USD exchange rate 1.10 1.07 The following table presents the long-term portion of the contingent consideration for the year ended December 31, 2023 and summarizes the change in fair value, as determined by Level 3 inputs for the contingent consideration for the year ended December 31, 2023 and 2022: Fair Value (in thousands) Balance at December 31, 2021 $ 2,371 Change in fair value (1,115 ) Balance at December 31, 2022 $ 1,256 Change in fair value 964 Balance at December 31, 2023 $ 2,220 Warrant Liabilities During 2023, the Company recorded warrant liabilities related to common stock warrants issued in the registered direct offering in July 2023 (for additional information about the offering, please refer to Note 14 -Equity Offerings). Warrant liabilities were recorded at their initial estimated fair value. Adjustments associated with changes in fair value of the warrant liabilities are included in the Company’s consolidated statements of operations and comprehensive loss. The following table summarizes changes in estimated fair value of the warrant liabilities for the warrants issued in July 2023 as of December 31, 2023: Fair Value (in thousands) Balance at December 31, 2022 $ - Issuance of warrants 7,120 Change in fair value (1,232 ) Balance at December 31, 2023 $ 5,888 The fair value of the warrant liabilities were estimated using the Black-Scholes option pricing model, which is based on unobservable inputs and is designated as Level 3 in the fair value hierarchy. The following table summarizes the assumptions used in determining fair value of warrant liabilities: As of December 31, 2023 Expected dividend yield 0 % Expected volatility 117 % Risk-free interest rate 3.8 % Expected life (in years) 4.6 |
Note 7 - Inventories
Note 7 - Inventories | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Inventory Disclosure [Text Block] | 7. Inventories The components of inventories are as follows: December 31, 2023 December 31, 2022 (in thousands) Finished goods $ 9,200 $ 11,208 Raw materials 2,015 2,545 Total inventories $ 11,215 $ 13,753 Current Portion $ 7,172 $ 8,284 Long-term portion 4,043 5,469 Total inventories $ 11,215 $ 13,753 |
Note 8 - Property and Equipment
Note 8 - Property and Equipment | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Property, Plant and Equipment Disclosure [Text Block] | 8. Property and Equipment Property and equipment consisted of the following: December 31, December 31, 2023 2022 (in thousands) Machinery, manufacturing, and demonstration equipment $ 9,089 $ 8,450 Operating lease assets - Senhance System leasing 12,848 10,251 Computer equipment 603 600 Furniture 715 831 Leasehold improvements 1,721 1,654 Construction in process 70 436 Total property and equipment 25,046 22,222 Accumulated depreciation and amortization (16,087 ) (12,680 ) Property and equipment, net $ 8,959 $ 9,542 Depreciation expense was approximately $3.3 million and $3.4 million for the years ended December 31, 2023 and 2022, respectively. |
Note 9 - Intellectual Property
Note 9 - Intellectual Property | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Intangible Assets Disclosure [Text Block] | 9. Intellectual Property The components of gross intellectual property, accumulated amortization, and net intellectual property are as follows: December 31, 2023 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount (in thousands) Developed technology $ 68,838 $ (66,902 ) $ (837 ) $ 1,099 Technology and patents purchased 400 (279 ) 17 138 Total intellectual property $ 69,238 $ (67,181 ) $ (820 ) $ 1,237 December 31, 2022 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount (in thousands) 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 3.2 years and 3.3 years, respectively, as of December 31, 2023. The weighted average remaining useful life of the developed technology and technology and patents purchased was 4.2 years and 4.3 years, respectively as of December 31, 2022. The estimated future amortization expense of intellectual property as of December 31, 2023 is as follows (in thousands): Year Ending 2024 $ 388 2025 388 2026 389 2027 72 Total $ 1,237 |
Note 10 - Leases
Note 10 - Leases | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Lessee, Operating Leases [Text Block] | 10. Leases Lessee Information Components of operating lease expense are primarily recorded in general and administrative on the consolidated statements of operations and comprehensive loss were as follows: Years Ended December 31, 2023 2022 (in thousands) Long-term operating $ 1,888 $ 1,557 Supplemental balance sheet information related to operating leases was as follows: Years Ended December 31, 2023 2022 Weighted-average remaining lease term (in years) 5.7 6.8 Weighted-average discount rate 9.2% 8.4% Incremental borrowing rate 7.1% - 23.0% 6.1% - 14.5% Maturities of finance and operating lease obligations as of December 31, 2023 were as follows (in thousands): Fiscal Year 2024 $ 1,491 2025 1,377 2026 1,160 2027 904 2028 834 Thereafter 1,406 Total minimum lease payments $ 7,172 Less: Amount of lease payments representing interest (1,490 ) Present value of future minimum lease payments $ 5,682 |
Note 11 - Accrued Expenses and
Note 11 - Accrued Expenses and Other Current Liabilities | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Accrued Liabilities [Text Block] | 11. Accrued Expenses and Other Current Liabilities The following table presents the components of accrued expenses and other current liabilities: Years Ended December 31, 2023 2022 (in thousands) Consulting and other vendors $ 461 $ 155 Royalties 9 24 Legal and professional fees 411 275 Taxes and other assessments 755 839 Total $ 1,636 $ 1,293 |
Note 12 - Income Taxes
Note 12 - Income Taxes | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Income Tax Disclosure [Text Block] | 12. Income Taxes The components for the income tax expense are as follows for the years ended December 31 (in thousands): 2023 2022 (in thousands) Current income taxes Federal $ - $ - State - - Foreign 196 239 Deferred income taxes - Federal - - State - - Foreign 118 79 Total income tax expense $ 314 $ 318 The United States and foreign components of loss from operations before taxes are as follows for the years ended December 31 (in thousands): 2023 2022 (in thousands) United States $ (53,226 ) $ (44,802 ) Foreign (24,893 ) (30,441 ) Total loss from operations before taxes $ (78,119 ) $ (75,243 ) Significant components of the Company’s deferred tax assets consist of the following at December 31 (in thousands): 2023 2022 (in thousands) Deferred Tax assets: Stock-based compensation $ 3,119 $ 2,840 Accrued expenses and other 2,666 2,538 Research credit carryforward 2,859 1,341 Fixed assets 319 162 Capitalized start-up costs and other intangibles 644 921 Capitalized research costs 9,064 4,382 Net operating loss carryforwards 93,332 83,908 112,003 96,092 Valuation allowance (110,511 ) (94,704 ) Net deferred tax asset 1,492 1,388 Deferred tax liabilities Fixed assets and other (1,448 ) (1,214 ) Net deferred tax liability (1,448 ) (1,214 ) Net deferred tax asset $ 44 $ 174 At December 31, 2023 and 2022, the Company has provided a full valuation allowance against its net deferred assets in the U.S., Canada, Italy, Luxembourg, Switzerland, and Taiwan tax jurisdictions, since realization of these benefits is not more likely than not. The valuation allowance increased approximately $15.8 million from the prior year. At December 31, 2023, the Company had U.S. federal net operating loss carryforwards of $446.7 million, of which $253 million are expected to expire unused under the limitations imposed by Internal Revenue Code Section 382. Of the total amount of Federal NOLs (notwithstanding the 382 limitation), $254.5 million begin to expire in 2027, while the remaining $192.2 million carry forward indefinitely. At December 31, 2023, the Company had U.S. state net operating loss carryforwards of $336.3 million, of which $199 million are expected to expire unused under the state tax law equivalents of Internal Revenue Code Section 382. Of this amount (notwithstanding the 382 limitations), $323.0 million of state NOLs begin to expire in 2024, while the remaining $13.3 million carry forward indefinitely. At December 31, 2023, the Company had federal research credit carryforwards in the amount of $11.7 million. These carryforwards begin to expire in 2027. However, under the limitations of Internal Revenue Code Section 383, it is expected that $8.8 million of this carryforward will expire unused. The utilization of the federal net operating loss carryforwards and credit carryforwards will depend on the Company’s ability to generate sufficient taxable income prior to the expiration of the carryforwards. At December 31, 2023, the Company had foreign operating loss carryforwards in Italy of approximately $25.0 million, which can be carried forward indefinitely; foreign operating loss carryforwards in Luxembourg of approximately $95.6 million, which will begin to expire in 2034; foreign operating loss carryforwards in Switzerland of approximately $135.3 million, which begin to expire in 2024, and foreign operating loss carryforwards in Canada of approximately $1.4 million, which begin to expire in 2040. The Company has evaluated its tax positions to consider whether it has any unrecognized tax benefits. As of December 31, 2023, the Company had gross unrecognized tax benefits of approximately $0.7 million. Of the total, none would reduce the Company’s effective tax rate if recognized. The Company does not anticipate a significant change in total unrecognized tax benefits or the Company’s effective tax rate due to the settlement of audits or the expiration of statutes of limitations within the next twelve months. Furthermore, the Company does not expect any cash settlement with the taxing authorities as a result of these unrecognized tax benefits as the Company has sufficient unutilized carryforward attributes to offset the tax impact of these adjustments. The following is a tabular reconciliation of the Company’s change in gross unrecognized tax positions at December 31 (in thousands): 2023 2022 (in thousands) Beginning balance $ 335 $ 141 Gross increases for tax positions related to current periods 328 194 Gross decreases related to 382 limitations 52 - Ending balance $ 715 $ 335 The Company recognizes interest and penalties related to uncertain tax positions in the provision for income taxes. As of December 31, 2023 and 2022, the Company had no The Company has analyzed its filing positions in all significant federal, state, and foreign jurisdictions where it is required to file income tax returns, as well as open tax years in these jurisdictions. With few exceptions, the Company is no longer subject to United States Federal, state, and local tax examinations by tax authorities for years before 2020, although carryforward attributes that were generated prior to 2020 may still be adjusted upon examination by the taxing authorities if they either have been or will be used in a future period. No income tax returns are currently under examination by taxing authorities. Taxes computed at the then-current statutory federal income tax rate of 21% are reconciled to the provision for income taxes as follows for the years ended December 31: 2023 2022 Amount Percent of Pretax Earnings Amount Percent of Pretax Earnings (in thousands) United States federal tax at statutory rate $ (16,405 ) 21.0 % $ (15,801 ) 21.0 % State taxes (net of deferred benefit) (2,493 ) 3.2 % (2,912 ) 3.9 % Nondeductible expenses 755 (1.0 %) 1,077 (1.4 %) Change in fair market value of contingent consideration 244 (0.3 %) (283 ) 0.4 % Warrant remeasurement and financing costs (140 ) 0.2 % - - Research & development (1,898 ) 2.4 % (970 ) 1.3 % Change in unrecognized tax benefits 380 (0.5 %) 194 (0.3 %) Foreign tax rate differential 3,176 (4.1 %) 2,676 (3.6 %) True-up to stock compensation - cancellations - - 49 (0.1 %) Change in enacted tax rates and other, net 659 (0.8 %) (96 ) 0.0 Change in valuation allowance 16,036 (20.5 %) 16,384 (21.8 %) Income tax expense (benefit) $ 314 (0.4 %) $ 318 (0.4 %) |
Note 13 - Stock-based Compensat
Note 13 - Stock-based Compensation | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Share-Based Payment Arrangement [Text Block] | 13. Stock-Based Compensation Incentive Compensation Plan Information On June 6, 2023, at the 2023 Annual Meeting of Stockholders, the Company’s stockholders voted to approve an amendment and restatement of the Company’s Incentive Compensation Plan (“the Plan”) to increase the number of shares reserved for issuance under the Plan by 22,000,000 shares. As of December 31, 2023, there were 54,072,307 shares authorized for issuance, and 22,185,899 shares available for future issuance under the Plan. To date all equity awards under the Plan have consisted of nonqualified stock options, incentive stock options, restricted stock units and stock awards. Under the Plan, which is administered by the Compensation Committee, the Company may grant stock options, stock appreciation rights, restricted stock units, restricted stock or stock awards to employees, officers, non-employee directors, consultants, and vendors. The exercise price of stock options or stock appreciation rights may not be less than the fair market value of the Company’s shares at the date of grant. Additionally, no stock options or stock appreciation rights granted under the Plan may have a term exceeding ten Stock Options The following table summarizes the Company’s stock option activity, including grants to non-employees, for the year ended December 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 3,047,615 0.71 Forfeited (149,430 ) 0.78 Cancelled (25,173 ) 27.32 Exercised (13,300 ) 0.38 Balance at December 31, 2023 10,444,679 $ 3.20 4.80 The weighted-average grant date fair value of stock options was $0.59 during the years ended December 31, 2023 and 2022. The aggregate intrinsic value of stock options exercised under the Company’s stock plans was not material during the years ended December 31, 2023 and 2022. The following table summarizes information about stock options outstanding at December 31, 2023: Number of Shares Weighted- Average Exercise Price Weighted-Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (Millions) Exercisable at December 31, 2023 5,726,280 $ 5.02 4.12 $ - Vested or expected to vest at December 31, 2023 10,105,084 $ 3.28 4.77 $ - The fair value of options granted were estimated using the Black-Scholes-Merton option pricing model based on the assumptions in the table below: Years Ended December 31, 2023 2022 Expected dividend yield 0% 0% Expected volatility 124% - 130% 126% - 133% Risk-free interest rate 3.53% - 4.14% 1.25% - 4.40% Expected life (in years) 3.8 - 4.5 3.8 - 4.5 Restricted Stock Units The following is a summary of the restricted stock unit activity, including performance restricted stock units, for the year ended December 31, 2023: Number of Restricted Stock Units Outstanding Weighted-Average Grant Date Fair Value Unvested December 31, 2022 8,483,491 $ 1.04 Granted 8,616,931 0.70 Vested (3,937,130 ) 1.10 Forfeited (837,115 ) 0.76 Unvested December 31, 2023 12,326,177 $ 0.81 Performance Restricted Stock Units In 2023 and 2022, the Company granted performance-based restricted stock units (“PRSUs”). The number of shares earnable under the 2023 and 2022 awards were based on achieving certain operational targets by December 31, 2023 (for the PRSUs granted in 2023) and October 1, 2023 (for the PRSUs granted in 2022), respectively. In February 2024, the Board determined that the operational targets for PRSU awards granted in 2023 were 50% achieved and as a result, the 2023 PRSUs were 50% earned and remain subject to three three Stock-based Compensation Expense The following table summarizes non-cash stock-based compensation expense by award type for the years ended December 31, 2023, and 2022: Years Ended December 31, 2023 2022 (in thousands) Stock options $ 2,338 $ 3,654 Restricted stock units 3,954 3,319 Performance restricted stock units 1,626 1,443 $ 7,918 $ 8,416 As of December 31, 2023, the unrecognized stock-based compensation expense related to unvested stock options was approximately $1.6 million, which is expected to be recognized over an estimated weighted-average period of 1.4 years. As of December 31, 2023, the unrecognized stock-based compensation expense related to unvested restricted stock units and performance restricted stock units was approximately $4.4 million, which is expected to be recognized over a weighted average period of approximately 1.2 years. |
Note 14 - Equity Offerings
Note 14 - Equity Offerings | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Equity [Text Block] | 14. Equity Offerings Equity financing transactions for the years ended December 31, 2023 and 2022, include: 2022 At-The-Market Offering On March 18, 2022, the Company entered into a Controlled Equity Offering Sales Agreement (the “2022 Sales Agreement”) with Cantor Fitzgerald & Co. and Oppenheimer & Co. Inc., collectively, “the Agents”. The Company commenced an at-the-market offering (the “2022 ATM Offering”) pursuant to which the Company could offer and sell, from time to time, at its option, shares of its common stock for an aggregate offering price of up to $100.0 million. The aggregate compensation payable to the Agents was 3.0% of the aggregate gross proceeds from each sale of the Company’s common stock. No shares were sold under the 2022 ATM Offering in 2022. The following table presents details about common stock issued pursuant to the 2022 ATM Offering (in thousands, except share and per share amounts): Year Ended December 31, 2023 Total shares of common stock sold 933,672 Average price per share $ 0.43 Gross proceeds $ 403 Commission paid to agents $ 12 Net proceeds $ 391 2023 Registered Equity Offering On July 27, 2023, the Company sold, in a registered direct offering, an aggregate of 23,809,524 shares of common stock, and warrants to purchase 23,809,524 of the Company’s common stock shares at an exercise price of $0.42 per common share (the “warrants”), for an aggregate purchase price of $10.0 million. The warrants are exercisable at any time on or after the date of issuance and will expire five The Company allocated $7.1 million of the aggregate proceeds to warrants based on their estimated fair value, with the residual amount of $2.9 million allocated to common stock. Offering related issuance costs were approximately $1.0 million and consisted primarily of placement agent’s fees and legal expenses. Issuance costs were allocated to common stock and warrant liability proportionally to the allocation of the purchase price. During the year ended December 31, 2023, the Company recorded $0.7 million of other expense, net, in the consolidated statement of operations related to issuance costs allocated to warrant liabilities. |
Note 15 - Basic and Diluted Net
Note 15 - Basic and Diluted Net Loss Per Share | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Earnings Per Share [Text Block] | 15. 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. Potential dilutive common shares consist of incremental shares issuable upon exercise of stock options, restricted stock units, and warrants. No Potential common shares not included in calculating diluted net loss per share are as follows: December 31, 2023 2022 Stock options 10,444,679 7,584,967 Nonvested restricted stock units 12,326,177 8,483,491 Stock warrants 24,830,500 1,021,076 Total 47,601,356 17,089,534 |
Note 16 - Commitments and Conti
Note 16 - Commitments and Contingencies | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Commitments and Contingencies Disclosure [Text Block] | 16. Commitments and Contingencies License and Supply Agreements As part of the Company’s acquisition of the Senhance System in 2015, the Company assumed certain license and supply agreements. The Company has purchase orders with various suppliers for certain tooling, supplies, contract engineering and research services. Commitments related to license agreements and purchase orders are as follows (in thousands): Fiscal Year 2024 $ 3,263 2025 300 2026 320 Total commitments $ 3,883 |
Note 17 - Segments and Geograph
Note 17 - Segments and Geographic Areas | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Segment Reporting Disclosure [Text Block] | 17. Segments and Geographic Areas The Company operates in one The following table presents consolidated assets and long-lived assets by geographic area, which includes property and equipment, intellectual property, and operating lease assets: December 31, 2023 Long-Lived Assets Total Assets US 29 % 46 % EMEA 68 % 52 % Asia 3 % 2 % Total 100 % 100 % December 31, 2022 Long-Lived Assets Total Assets US 35 % 72 % 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. Years Ended December 31, 2023 2022 US 8 % 11 % EMEA 82 % 77 % Asia 10 % 12 % Total 100 % 100 % |
Note 18 - Related Party Transac
Note 18 - Related Party Transactions | 12 Months Ended |
Dec. 31, 2023 | |
Notes to Financial Statements | |
Related Party Transactions Disclosure [Text Block] | 18. Related Party Transactions In March 2018, Asensus Surgical Europe S.à r.l. entered into a Service Supply Agreement with 1 Med S.A. for certain regulatory consulting services. Andrea Biffi, a current member of the Company’s Board of Directors, owns a non-controlling interest in 1 Med S.A. Expenses under the Service Supply Agreement were approximately $0.1 million and $0.3 million for the years ended December 31, 2023 and 2022, respectively. In October 2023, Asensus Surgical US, Inc. entered into an agreement with Synchrony Labs, LLC to support preclinical evaluation of the LUNA Surgical System. William Starling, a current member of the Company’s Board of Directors, owns more than 10% of Synchrony Labs, LLC. Expenses under the agreement were approximately $0.1 million for the year ended December 31, 2023. |
Insider Trading Arrangements
Insider Trading Arrangements | 3 Months Ended | 12 Months Ended |
Dec. 31, 2023 | Dec. 31, 2023 | |
Insider Trading Arr Line Items | ||
Material Terms of Trading Arrangement [Text Block] | 9.B. OTHER INFORMATION During the three months ended December 31, 2023, none | |
Rule 10b5-1 Arrangement Adopted [Flag] | false | |
Rule 10b5-1 Arrangement Terminated [Flag] | false | |
Non-Rule 10b5-1 Arrangement Adopted [Flag] | false | |
Non-Rule 10b5-1 Arrangement Terminated [Flag] | false |
Significant Accounting Policies
Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2023 | |
Accounting Policies [Abstract] | |
Basis of Accounting, Policy [Policy Text Block] | Basis of Presentation The accompanying 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. |
Substantial Doubt about Going Concern [Policy Text Block] | Going Concern The Company's 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 $939.4 million and working capital of $23.8 million as of December 31, 2023. The Company has not established sufficient sales revenues to cover its operating costs and requires additional capital to proceed with its operating plan. The ability of the Company to continue as a going concern is dependent on the Company obtaining adequate capital to fund operating losses until it becomes profitable. 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 include additional sales of equity, traditional financing, such as loans, entry into a strategic collaboration, entry into an out-licensing arrangement or provision of additional distribution rights in some or all of our markets. However, management cannot provide any assurance that the Company will be successful in accomplishing any or all of its plans. The ability to successfully resolve these factors raise substantial doubt about the Company’s ability to meet its existing obligations, and to continue as a going concern within one year from the date that these financial statements are issued. The consolidated financial statements of the Company do not include any adjustments that may result from the outcome of these aforementioned uncertainties. |
Consolidation, Policy [Policy Text Block] | Principles of Consolidation and Foreign Currency Considerations The accompanying consolidated financial statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., Asensus International, Inc., Asensus Surgical Italia S.r.l., Asensus Surgical Europe S.à r.l., Asensus Surgical Taiwan Ltd., Asensus Surgical Japan K.K., Asensus Surgical Israel Ltd., Asensus Surgical Netherlands B.V., and Asensus Surgical Canada, Inc. All inter-company accounts and transactions have been eliminated in consolidation. The functional currency of the Company’s operational foreign subsidiaries is predominantly the Euro. The assets and liabilities of the Company’s foreign subsidiaries are translated into U.S. dollars at exchange rates in effect at the balance sheet date. Income and expense items are translated at the average exchange rates prevailing during the period. The cumulative translation effect for a subsidiary using a functional currency other than the U.S. dollar is included in accumulated other comprehensive loss as a separate component of stockholders’ equity which was $0.6 million and $1.9 million as of December 31, 2023 and 2022, respectively. The Company’s intercompany accounts are denominated in the functional currency of the foreign subsidiary. Gains and losses resulting from the remeasurement of intercompany receivables that the Company considers to be of a long-term investment nature are recorded as a cumulative translation adjustment in accumulated other comprehensive loss as a separate component of stockholders’ equity, while gains and losses resulting from the remeasurement of intercompany receivables from a foreign subsidiary for which the Company anticipates settlement in the foreseeable future are recorded in the consolidated statements of operations and comprehensive loss. The net gains and losses included in net loss in the consolidated statements of operations and comprehensive loss for the years ended December 31, 2023 and 2022 were not material. |
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, obtain regulatory clearance for and commercialize its products and products in development; negative impacts on the Company's operations caused by the hostilities in the Middle East and other geopolitical factors; the success of its market development efforts; the timing and outcome of the regulatory review process for its products; changes in the healthcare regulatory environments of the United States, the European Union, Japan, Taiwan and other countries in which the Company operates or intends to operate; its ability to attract and retain key management, marketing and scientific personnel; its ability to successfully prepare, file, prosecute, maintain, defend and enforce patent claims and other intellectual property rights; its ability to successfully transition from a research and development company to a marketing, sales and distribution company; competition in the market for robotic and digital surgical devices; and its ability to identify and pursue development of additional products. |
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 investments, changes in 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. |
Cash and Cash Equivalents, Restricted Cash, and Investments, Policy [Policy Text Block] | Cash and Cash Equivalents, Restricted Cash, and Investments The Company considers all highly liquid investments with original maturities of 90 days or less at the time of purchase to be cash equivalents. Restricted cash as of December 31, 2023 and 2022 includes $1.6 million and $1.1 million, respectively, in cash accounts held as collateral primarily under the terms of office operating leases, credit cards, and automobile leases, and a guarantee required by the government of a country for a 2019 VAT refund. The Company’s investments as of December 31, 2023 consisted of corporate bonds that were classified as available-for-sale. Investments classified as available-for-sale are measured at fair value, and net unrealized gains and losses are recorded as a component of accumulated other comprehensive loss on the consolidated balance sheets until realized. The amortized cost of debt securities is adjusted for amortization of premiums and accretion of discounts to maturity computed under the effective interest method. Such amortization and accretion are included in interest expense, net. There were no Investments with remaining maturities at date of purchase greater than 90 days and remaining maturities as of the reporting period less than one year are classified as short-term investments. Investments with remaining maturities greater than one year are classified as long-term investments. There have been no no |
Fair Value Measurement, Policy [Policy Text Block] | Fair Value Measurements The Company measures the fair value of money market funds, certain U.S. treasury securities, and equity investments with readily determinable value based on quoted prices in active markets for identical assets as Level 1 securities. Marketable securities measured at fair value using Level 2 inputs are primarily comprised of commercial paper and corporate notes and bonds without readily determinable value. The Company reviews trading activity and pricing for these investments as of the measurement date. When sufficient quoted pricing for identical securities is not available, the Company uses market pricing and other observable market inputs for similar securities obtained from various third-party data providers. These inputs either represent quoted prices for similar assets in active markets or have been derived from observable market data. This approach results in the Level 2 classification of these securities within the fair value hierarchy. The Company measures contingent consideration at fair value using a Monte-Carlo simulation utilizing Level 3 inputs. These inputs include the probability of achieving each of the potential milestones, revenue volatility, and an estimated discount rate associated with the risks of the expected cash flows attributable to the achievement of various milestones. |
Concentration Risk, Credit Risk, Policy [Policy Text Block] | Concentrations and Credit Risk The Company’s principal financial instruments subject to potential concentration of credit risk are cash and cash equivalents (including restricted cash), and investments, including amounts held in money market funds, commercial paper, and corporate bonds. The Company places cash deposits with a federally insured financial institution. The Company maintains its cash at banks and financial institutions it considers to be of high credit quality; however, the Company’s domestic cash deposits may at times exceed the Federal Deposit Insurance Corporation’s insured limit. Balances in excess of federally insured limitations may not be insured. The Company has not experienced losses on these accounts, and management believes that the Company is not exposed to significant risks on such accounts. Investments are stated at their estimated fair values, based on quoted market prices for the same or similar instruments. The counterparties to the agreements relating to the Company’s investments consist of various major corporations, financial institutions, and government agencies of high credit standing. The Company’s accounts receivable are derived from sales and leases to customers located throughout the world. The Company evaluates its customers’ financial condition and, generally, requires no collateral from its customers. The Company had one two one |
Receivable [Policy Text Block] | 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 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 and future economic conditions that may affect a customer’s ability to pay. The allowance for expected credit losses was $1.6 million as of December 31, 2023 and 2022. |
Inventory, Policy [Policy Text Block] | Inventories Inventories are stated at the lower of cost (determined on a first-in, first-out basis) or net realizable value. Inventory costs include direct materials, direct labor, and normal manufacturing overhead. The Company records reserves, when necessary, to reduce the carrying value of inventory to its net realizable value. Management considers historical consumption and forecast demand in relation to the inventory on hand, competitiveness of product offerings, market conditions and product life cycles when determining excess and obsolescence and net realizable value adjustments. At the point of loss recognition, a new, lower-cost basis for that inventory is established, and any subsequent improvements in facts and circumstances do not result in the restoration or increase in that newly established cost basis. Any inventory on hand at the measurement date in excess of the Company's current requirements based on anticipated levels of sales is classified as long-term on the Company's consolidated balance sheets. The Company's classification of long-term inventory requires it to estimate the portion of on hand inventory that can be realized over the upcoming twelve months. |
Goodwill and Intangible Assets, Policy [Policy Text Block] | Definite-Lived Intangible Assets - Intellectual Property Intellectual property consists of purchased patent rights and developed technology acquired as part of a business acquisition. Developed technology includes reclassified in-process research and development (“IPR&D”) assets related to (i) the Senhance System acquired in 2015 and reclassified in 2017 and (ii) a 2018 acquisition and reclassified in 2020. Amortization of the patent rights is recorded using the straight-line method over the estimated useful life of the patents of 10 years. Amortization of the developed technology is recorded using the straight-line method over the estimated useful life of 7 years. The Company periodically evaluates intellectual property for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. To determine the recoverability, the Company evaluates the probability that future estimated undiscounted net cash flows will be less than the carrying amount of the assets. If such estimated cash flows are less than the carrying amount of the assets, then such assets are written down to their fair value. No |
Property, Plant and Equipment, Policy [Policy Text Block] | Property and Equipment Property and equipment consists primarily of operating lease Senhance System assets, machinery, manufacturing equipment, demonstration equipment, computer equipment, furniture, and leasehold improvements, which are recorded at cost less accumulated depreciation. Depreciation is recorded using the straight-line method over the estimated useful lives of the assets as follows: Years Operating lease assets – Senhance System leasing 5 Machinery, manufacturing, and demonstration equipment 3 - 5 Computer equipment 3 Furniture 5 Leasehold improvements Lesser of lease term or 3-10 The Company reviews its property and equipment assets for possible impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not be fully recoverable. To determine the recoverability of its long-lived assets, the Company evaluates the probability that future estimated undiscounted net cash flows will be less than the carrying amount of the assets. If such estimated cash flows are less than the carrying amount of the long-lived assets, then such assets are written down to their fair value. During the years ended December 31, 2023 and 2022, the Company recorded a non-cash asset impairment charge of $0.4 million and $1.4 million, respectively, to reduce the carrying value of property and equipment to its estimated fair value. The property and equipment impairment is associated with returned Senhance Systems under operating leases and Senhance Systems currently under operating leases that are not expected to generate future cash flows sufficient to recover their net book value. The fair value was estimated based on the discounted cash flows expected to be produced by the property and equipment. The impairment was recorded in property and equipment impairment on the consolidated statements of operations and comprehensive loss. |
Lessee, Leases [Policy Text Block] | Operating Leases The Company has operating leases for its corporate office buildings, vehicles, and machinery and equipment. At inception, the Company determines whether an agreement represents a lease, and at commencement, it evaluates each lease agreement to determine whether the lease constitutes an operating or financing lease. The Company accounts for lease components and non-lease components as a single component. Non-lease components consist of common area maintenance payments for most real estate leases, which are determined based on costs incurred by the lessor. Many of the Company’s leases include base rental periods coupled with options to renew or terminate the lease, generally at the Company’s discretion. In evaluating the lease term, the Company considers whether renewal is reasonably certain. To the extent a significant economic incentive exists to renew the lease, the option is included within the lease term. Based on the Company’s leases, renewal options generally do not provide a significant economic incentive and are therefore excluded from the lease term. While its operating leases range from one ten one six The interest rate implicit in lease contracts is typically not readily determinable. As such, the Company utilizes the appropriate incremental borrowing rate, which is the rate incurred to borrow on a collateralized basis over a similar term an amount equal to the lease payments in a similar economic environment. Operating lease expense is recognized on a straight-line basis over the lease term, subject to any changes in the lease or expectations regarding the terms. |
Capitalization of Internal Costs, Policy [Policy Text Block] | Implementation Costs in a Cloud Computing Arrangement The Company capitalizes qualified implementation costs incurred in a hosting arrangement that is a service contract. These capitalized implementation costs are recorded within other current and long-term assets, and are generally amortized over the fixed, non-cancellable term of the associated hosting arrangement on a straight-line basis and included within operating expenses. |
Employer Retention Tax Credit, Policy [Policy Text Block] | Employee Retention Tax Credit Receivable The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) included an Employee Retention Tax Credit (“ERTC”) provision designed to encourage employers to keep employees on their payroll. The ERTC is a refundable tax credit against certain payroll taxes paid by employers for eligible wages. During the year ended December 31, 2021, the Company submitted an ERTC refund for $1.3 million and recorded the amount into Other Income (Expense) on the consolidated statements of operations and comprehensive loss. The Company received $0.7 million of the ERTC refund during the year ended December 31, 2022 and received the remaining $0.6 million during the year ended December 31, 2023. |
Contingent Consideration [Policy Text Block] | Contingent Consideration Contingent consideration is recorded as a liability and is the estimate of the fair value of potential milestone payments related to business acquisitions. Contingent consideration is measured at fair value using a Monte-Carlo simulation utilizing significant unobservable inputs including the probability of achieving each of the potential milestones, future Euro-to-USD exchange rates, revenue volatility and an estimated discount rate associated with the risks of the expected cash flows attributable to the various milestones. Significant increases or decreases in any of the probabilities of success or changes in expected achievement of any of these milestones would result in a significantly higher or lower fair value of these milestones, respectively, and commensurate changes to the associated liability. The contingent consideration is revalued at each reporting period and changes in fair value are recognized in the consolidated statements of operations and comprehensive loss. On September 21, 2015, the Company completed the strategic acquisition, through its wholly owned subsidiary TransEnterix International, from Sofar S.p.A., an Italian company (“Sofar”), an Italian company, of all of the assets, employees and contracts related to the advanced robotic system for minimally invasive laparoscopic surgery now known as the Senhance System. Under the terms of the Purchase Agreement, as amended in 2016, as of December 31, 2023, the Company has accrued $2.2 million of estimated fair value of remaining contingent consideration related to a milestone of €15.0 €25.0 |
Warrant Liabilities [Policy Text Block] | Warrant Liabilities The Company’s warrants (see “Note 14 – Equity Offerings,”) are measured at fair value using a Black-Scholes-Merton model option-pricing model which takes into account, as of the valuation date, factors including the current exercise price, the expected life of the warrant, the current price of the underlying stock, its expected stock price volatility, the expected dividend yield which is assumed to be zero since The Company has not paid and does not anticipate paying cash dividends on its shares of common stock and the risk-free interest rate is based on U.S. Treasury rates whose term is consistent with the term of the warrant (see “Note 6 – Fair Value,”). The warrant liability is revalued at each reporting period and changes in fair value are recognized in the consolidated statements of operations and comprehensive loss. |
Revenue [Policy Text Block] | Revenue Recognition The Company’s revenue consists of product revenue resulting from the sale of Senhance Systems, Senhance System components, and instruments and accessories. Service revenue consists of revenue related to Senhance System service agreements. Lease revenue consists of revenue generated from utilizing the Senhance System, instruments and accessories, and servicing of the Senhance System under operating lease agreements. The Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and the customer, the rights of the parties are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company's revenues are measured based on considerations specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government authorities. The Company’s Senhance System sale arrangements could include a five four The Company’s Senhance System sale arrangements generally contain multiple products and services. For these consolidated sale arrangements, the Company accounts for individual products and services as separate performance obligations if they are distinct, which is if a product or service is separately identifiable from other items in the consolidated package, and if a customer can benefit from it on its own or with other resources that are readily available to the customer. The Company’s Senhance System sale arrangements may include a combination of the following performance obligations: system(s), system components, instruments, accessories, and system services. For arrangements that contain multiple performance obligations, revenue is allocated to each performance obligation based on its relative estimated standalone selling price. When available, standalone selling prices are based on observable prices at which the Company separately sells the products or services. The Company recognizes revenues when or as the performance obligations are satisfied by transferring control of the product or service to a customer. The Company generally recognizes revenue for the performance obligations as follows: ● System sales. For Senhance Systems and Senhance System components sold directly to end customers (including those arising from Senhance System purchases under lease rights to purchase), revenue is recognized when the Company transfers control to the customer, which is generally at the point when acceptance occurs that indicates customer acknowledgment of delivery or installation, depending on the terms of the arrangement. For lease buyouts, where the customer has already acknowledged installation of the system, transfer of control occurs when the Company receives an executed contract for the lease buyout of the Senhance System. For Senhance Systems sold through distributors, for which distributors are responsible for installation, revenue is recognized generally upon delivery. The Company’s Senhance System arrangements generally do not provide a right of return. The Senhance Systems are generally covered by a one-year warranty. Warranty costs were not material for the periods presented. ● Instruments and accessories. Revenue from sales of instruments and accessories is recognized when control is transferred to the customers, which generally occurs at the time of shipment, but also occurs at the time of delivery depending on the customer arrangement. ● Service. Service revenue is recognized ratably over the term of the service period as the customers benefit from the service throughout the service period. Revenue related to services performed on a time-and-materials basis is recognized when performed. The Company invoices its customers based on the billing schedules in its sales arrangements. Payments are generally due 30 to 60 days from the date of invoice. Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative selling price of the related performance obligations and the contractual billing terms in the arrangements and are included in accounts receivable. In connection with assets recognized from the costs to obtain a contract with a customer, the Company determined that the sales incentive programs for its sales team do not meet the requirements to be capitalized as the Company does not expect to generate future economic benefits from the related revenue from the initial sales transaction and such costs are expensed as incurred. |
Lessor, Leases [Policy Text Block] | Senhance System Leasing The Company enters into lease arrangements with certain qualified customers. Revenue related to arrangements including lease elements are allocated to lease and non-lease elements based on their relative standalone selling prices. Lease elements generally include a Senhance System, while non-lease elements generally include instruments, accessories, and services. For some lease arrangements, the customers are provided with the right to purchase the leased 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 years ended December 31, 2023 and 2022, variable lease revenue related to usage-based arrangements was not material. In determining whether a transaction should be classified as a sales-type, operating, or direct financing lease, the Company considers the following terms at lease commencement: (1) whether title of the Senhance System transfers automatically or for a nominal fee by the end of the lease term, (2) whether the present value of the minimum lease payments equals or exceeds substantially all of the fair value of the leased Senhance System, (3) whether the lease term is for the major part of the remaining economic life of the leased System, (4) whether the lease grants the lessee an option to purchase the leased Senhance System that the lessee is reasonably certain to exercise, and (5) whether the underlying Senhance System is of such a specialized nature that it is expected to have no alternative use to the Company at the end of the lease term. All such arrangements through December 31, 2023 are classified as operating leases. Revenue related to lease elements from operating lease arrangements is generally recognized on a straight-line basis over the lease term or based upon Senhance System usage. As of December 31, 2023, future minimum lease payments due from customers was $2.2 million, which is expected to be received over the next one to two years. |
Cost of Goods and Service [Policy Text Block] | Cost of Revenue Cost of revenue consists of contract manufacturing, materials, labor and manufacturing overhead incurred internally to produce the products. Depreciation expense related to leased systems is included in the cost of revenue. Shipping and handling costs incurred by the Company are included in the cost of revenue. We expense all inventory obsolescence provisions as cost of revenue. |
Research and Development Expense, Policy [Policy Text Block] | Research and Development Costs Research and development expenses primarily consist of engineering, product development and regulatory expenses, incurred in the design, development, testing and enhancement of our products. Research and development costs are expensed as incurred. |
Share-Based Payment Arrangement [Policy Text Block] | Stock-Based Compensation The Company recognizes expenses for share-based awards exchanged for services rendered equal to the estimated fair value of these awards over the requisite service period. The Company recognizes as expense, the grant-date fair value of stock options and other stock-based compensation issued to employees and non-employee directors over the requisite service periods, which are typically the vesting periods. The Company uses the Black-Scholes-Merton model to estimate the fair value of stock options. The volatility assumption used in the Black-Scholes-Merton model is based on the Company’s historical volatility. The expected term of options granted has been determined based upon the simplified method, because the Company does not have sufficient historical information regarding its options to derive the expected term. Under this approach, the expected term is the mid-point between the weighted average of vesting period and the contractual term. The risk-free interest rate is based on U.S. Treasury rates whose term is consistent with the expected life of the stock options. The Company has not paid and does not anticipate paying cash dividends on its shares of common stock; therefore, the expected dividend yield is assumed to be zero The fair value of restricted stock units is determined by the market price of the Company’s common stock on the date of grant. See “Note 13 – Stock-Based Compensation,” for a detailed discussion of the Company’s stock plans and stock-based compensation expense. |
Income Tax, Policy [Policy Text Block] | Income Taxes The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets or liabilities for the temporary differences between financial reporting and tax basis of the Company’s assets and liabilities, and for tax carryforwards at enacted statutory rates in effect for the years in which the asset or liability is expected to be realized. The effect on deferred taxes of a change in tax rates is recognized in income during the period that includes the enactment date. In addition, valuation allowances are established when necessary to reduce deferred tax assets and liabilities to the amounts expected to be realized. The Company has elected to account for global intangible low-taxed income (“GILTI”) as a period expense in the year the tax is incurred. The Company recognizes the financial statement benefit of an income tax position only after determining that the relevant taxing authority would more likely than not sustain the position following audit. For tax positions meeting the more likely than not threshold, the amount recognized in the financial statements is the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement with the relevant taxing authority. The Company recognizes interest accrued related to unrecognized tax benefits and penalties in the provision for income taxes. Tax regulations within each jurisdiction are subject to the interpretation of the related tax laws and regulations and require application of significant judgment. The Company is subject to U.S. federal and various state, local and foreign jurisdictions. Due to the Company’s net operating loss carryforwards, the Company may be subject to examination by authorities for all previously filed income tax returns. |
Comprehensive Income, Policy [Policy Text Block] | Comprehensive Loss Comprehensive loss is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. |
Segment Reporting, Policy [Policy Text Block] | Segments The Company operates in one |
New Accounting Pronouncements, Policy [Policy Text Block] | Impact of Recently Issued Accounting Standards In November 2023, the FASB issued Accounting Standards Update, or ASU, No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures The ASU is to be applied retrospectively to all prior periods presented in the financial statements with an effective date for all public entities for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted. The Company is currently evaluating the impact of this ASU. In December 2023, the FASB issues ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures This ASU is to be applied on a prospective basis with an effective date for all public entities for annual periods beginning after December 15, 2024. Early adoption is permitted. The Company is currently evaluating the impact of this ASU. |
Note 2 - Summary of Significa_2
Note 2 - Summary of Significant Accounting Policies (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Schedule of Property Plant and Equipment Useful Life [Table Text Block] | Years Operating lease assets – Senhance System leasing 5 Machinery, manufacturing, and demonstration equipment 3 - 5 Computer equipment 3 Furniture 5 Leasehold improvements Lesser of lease term or 3-10 |
Note 3 - Revenue Recognition (T
Note 3 - Revenue Recognition (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Disaggregation of Revenue [Table Text Block] | Years Ended December 31, 2023 2022 (in thousands) U.S. Instruments and accessories $ 205 $ 211 Services 294 300 Leases 196 256 Total U.S. revenue 695 767 Outside of U.S. ("OUS") Systems 3,645 2,551 Instruments and accessories 1,669 1,565 Services 758 1,073 Leases 1,810 1,131 Total OUS revenue 7,882 6,320 Total Systems 3,645 2,551 Instruments and accessories 1,874 1,776 Services 1,052 1,373 Leases 2,006 1,387 Total revenue $ 8,577 $ 7,087 |
Contract with Customer, Contract Asset, Contract Liability, and Receivable [Table Text Block] | December 31, 2023 December 31, 2022 (in thousands) Contract assets $ 95 $ 116 Deferred revenue $ 711 $ 465 |
Note 4 - Cash, Cash Equivalen_2
Note 4 - Cash, Cash Equivalents, and Restricted Cash (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Schedule of Cash, Cash Equivalents, and Restricted Cash [Table Text Block] | December 31, December 31, 2023 2022 (in thousands) Cash $ 4,588 $ 3,473 Money market 5,521 2,856 U.S. treasuries 6,987 - Total cash and cash equivalents $ 17,096 $ 6,329 Restricted cash 1,642 1,141 Total $ 18,738 $ 7,470 |
Note 5 - Investments, Availab_2
Note 5 - Investments, Available-for-sale (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Debt Securities, Available-for-Sale [Table Text Block] | December 31, 2023 Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments (in thousands) Corporate bonds $ 3,981 $ - $ (10 ) $ 3,971 $ 3,971 Total investments $ 3,981 $ - $ (10 ) $ 3,971 $ 3,971 December 31, 2022 Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments (in thousands) 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] | December 31, 2023 Amortized Cost Fair Value (in thousands) Mature in less than one year $ 3,981 $ 3,971 Total $ 3,981 $ 3,971 |
Note 6 - Fair Value (Tables)
Note 6 - Fair Value (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Fair Value, Assets Measured on Recurring Basis [Table Text Block] | December 31, 2023 Quoted Prices Markets for Significant Significant Total Description (in thousands) Assets measured at fair value Cash and cash equivalents (1) $ 17,096 $ - $ - $ 17,096 Restricted cash 1,642 - - 1,642 Short-term investments - 3,971 - 3,971 Total assets measured at fair value $ 18,738 $ 3,971 $ - $ 22,709 Liabilities measured at fair value Contingent consideration $ - $ - $ 2,220 $ 2,220 Warrant Liabilities - - 5,888 5,888 Total liabilities measured at fair value $ - $ - $ 8,108 $ 8,108 December 31, 2022 Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Description (in thousands) 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 Significant Input December 31, December 31, Contingent consideration Probability Milestone dates 2032 2032 Discount rate 10.0 % 16.5 % Revenue volatility 35.0 % 45.0 % EUR-to-USD exchange rate 1.10 1.07 As of December 31, 2023 Expected dividend yield 0 % Expected volatility 117 % Risk-free interest rate 3.8 % Expected life (in years) 4.6 |
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block] | Fair Value (in thousands) Balance at December 31, 2021 $ 2,371 Change in fair value (1,115 ) Balance at December 31, 2022 $ 1,256 Change in fair value 964 Balance at December 31, 2023 $ 2,220 |
Fair Value, Liabilities Measured on Recurring Basis [Table Text Block] | Fair Value (in thousands) Balance at December 31, 2022 $ - Issuance of warrants 7,120 Change in fair value (1,232 ) Balance at December 31, 2023 $ 5,888 |
Note 7 - Inventories (Tables)
Note 7 - Inventories (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Schedule of Inventory, Current [Table Text Block] | December 31, 2023 December 31, 2022 (in thousands) Finished goods $ 9,200 $ 11,208 Raw materials 2,015 2,545 Total inventories $ 11,215 $ 13,753 Current Portion $ 7,172 $ 8,284 Long-term portion 4,043 5,469 Total inventories $ 11,215 $ 13,753 |
Note 8 - Property and Equipme_2
Note 8 - Property and Equipment (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Property, Plant and Equipment [Table Text Block] | December 31, December 31, 2023 2022 (in thousands) Machinery, manufacturing, and demonstration equipment $ 9,089 $ 8,450 Operating lease assets - Senhance System leasing 12,848 10,251 Computer equipment 603 600 Furniture 715 831 Leasehold improvements 1,721 1,654 Construction in process 70 436 Total property and equipment 25,046 22,222 Accumulated depreciation and amortization (16,087 ) (12,680 ) Property and equipment, net $ 8,959 $ 9,542 |
Note 9 - Intellectual Property
Note 9 - Intellectual Property (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Schedule of Finite-Lived Intangible Assets [Table Text Block] | December 31, 2023 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount (in thousands) Developed technology $ 68,838 $ (66,902 ) $ (837 ) $ 1,099 Technology and patents purchased 400 (279 ) 17 138 Total intellectual property $ 69,238 $ (67,181 ) $ (820 ) $ 1,237 December 31, 2022 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount (in thousands) 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 |
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block] | Year Ending 2024 $ 388 2025 388 2026 389 2027 72 Total $ 1,237 |
Note 10 - Leases (Tables)
Note 10 - Leases (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Lease, Cost [Table Text Block] | Years Ended December 31, 2023 2022 (in thousands) Long-term operating $ 1,888 $ 1,557 |
Lessee, Operating Lease, Disclosure [Table Text Block] | Years Ended December 31, 2023 2022 Weighted-average remaining lease term (in years) 5.7 6.8 Weighted-average discount rate 9.2% 8.4% Incremental borrowing rate 7.1% - 23.0% 6.1% - 14.5% |
Lessee, Operating Lease, Liability, to be Paid, Maturity [Table Text Block] | Fiscal Year 2024 $ 1,491 2025 1,377 2026 1,160 2027 904 2028 834 Thereafter 1,406 Total minimum lease payments $ 7,172 Less: Amount of lease payments representing interest (1,490 ) Present value of future minimum lease payments $ 5,682 |
Note 11 - Accrued Expenses an_2
Note 11 - Accrued Expenses and Other Current Liabilities (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Schedule of Accrued Liabilities [Table Text Block] | Years Ended December 31, 2023 2022 (in thousands) Consulting and other vendors $ 461 $ 155 Royalties 9 24 Legal and professional fees 411 275 Taxes and other assessments 755 839 Total $ 1,636 $ 1,293 |
Note 12 - Income Taxes (Tables)
Note 12 - Income Taxes (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block] | 2023 2022 (in thousands) Current income taxes Federal $ - $ - State - - Foreign 196 239 Deferred income taxes - Federal - - State - - Foreign 118 79 Total income tax expense $ 314 $ 318 |
Schedule of Income before Income Tax, Domestic and Foreign [Table Text Block] | 2023 2022 (in thousands) United States $ (53,226 ) $ (44,802 ) Foreign (24,893 ) (30,441 ) Total loss from operations before taxes $ (78,119 ) $ (75,243 ) |
Schedule of Deferred Tax Assets and Liabilities [Table Text Block] | 2023 2022 (in thousands) Deferred Tax assets: Stock-based compensation $ 3,119 $ 2,840 Accrued expenses and other 2,666 2,538 Research credit carryforward 2,859 1,341 Fixed assets 319 162 Capitalized start-up costs and other intangibles 644 921 Capitalized research costs 9,064 4,382 Net operating loss carryforwards 93,332 83,908 112,003 96,092 Valuation allowance (110,511 ) (94,704 ) Net deferred tax asset 1,492 1,388 Deferred tax liabilities Fixed assets and other (1,448 ) (1,214 ) Net deferred tax liability (1,448 ) (1,214 ) Net deferred tax asset $ 44 $ 174 |
Schedule of Unrecognized Tax Benefits Roll Forward [Table Text Block] | 2023 2022 (in thousands) Beginning balance $ 335 $ 141 Gross increases for tax positions related to current periods 328 194 Gross decreases related to 382 limitations 52 - Ending balance $ 715 $ 335 |
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block] | 2023 2022 Amount Percent of Pretax Earnings Amount Percent of Pretax Earnings (in thousands) United States federal tax at statutory rate $ (16,405 ) 21.0 % $ (15,801 ) 21.0 % State taxes (net of deferred benefit) (2,493 ) 3.2 % (2,912 ) 3.9 % Nondeductible expenses 755 (1.0 %) 1,077 (1.4 %) Change in fair market value of contingent consideration 244 (0.3 %) (283 ) 0.4 % Warrant remeasurement and financing costs (140 ) 0.2 % - - Research & development (1,898 ) 2.4 % (970 ) 1.3 % Change in unrecognized tax benefits 380 (0.5 %) 194 (0.3 %) Foreign tax rate differential 3,176 (4.1 %) 2,676 (3.6 %) True-up to stock compensation - cancellations - - 49 (0.1 %) Change in enacted tax rates and other, net 659 (0.8 %) (96 ) 0.0 Change in valuation allowance 16,036 (20.5 %) 16,384 (21.8 %) Income tax expense (benefit) $ 314 (0.4 %) $ 318 (0.4 %) |
Note 13 - Stock-based Compens_2
Note 13 - Stock-based Compensation (Tables) | 12 Months Ended |
Dec. 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 3,047,615 0.71 Forfeited (149,430 ) 0.78 Cancelled (25,173 ) 27.32 Exercised (13,300 ) 0.38 Balance at December 31, 2023 10,444,679 $ 3.20 4.80 |
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 December 31, 2023 5,726,280 $ 5.02 4.12 $ - Vested or expected to vest at December 31, 2023 10,105,084 $ 3.28 4.77 $ - |
Schedule of Share-Based Payment Award, Stock Options, Valuation Assumptions [Table Text Block] | Years Ended December 31, 2023 2022 Expected dividend yield 0% 0% Expected volatility 124% - 130% 126% - 133% Risk-free interest rate 3.53% - 4.14% 1.25% - 4.40% Expected life (in years) 3.8 - 4.5 3.8 - 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 8,616,931 0.70 Vested (3,937,130 ) 1.10 Forfeited (837,115 ) 0.76 Unvested December 31, 2023 12,326,177 $ 0.81 |
Share-Based Payment Arrangement, Cost by Plan [Table Text Block] | Years Ended December 31, 2023 2022 (in thousands) Stock options $ 2,338 $ 3,654 Restricted stock units 3,954 3,319 Performance restricted stock units 1,626 1,443 $ 7,918 $ 8,416 |
Note 14 - Equity Offerings (Tab
Note 14 - Equity Offerings (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Schedule of Sales Under Sales Agency Agreement [Table Text Block] | Year Ended December 31, 2023 Total shares of common stock sold 933,672 Average price per share $ 0.43 Gross proceeds $ 403 Commission paid to agents $ 12 Net proceeds $ 391 |
Note 15 - Basic and Diluted N_2
Note 15 - Basic and Diluted Net Loss Per Share (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block] | December 31, 2023 2022 Stock options 10,444,679 7,584,967 Nonvested restricted stock units 12,326,177 8,483,491 Stock warrants 24,830,500 1,021,076 Total 47,601,356 17,089,534 |
Note 16 - Commitments and Con_2
Note 16 - Commitments and Contingencies (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Contractual Obligation, Fiscal Year Maturity [Table Text Block] | Fiscal Year 2024 $ 3,263 2025 300 2026 320 Total commitments $ 3,883 |
Note 17 - Segments and Geogra_2
Note 17 - Segments and Geographic Areas (Tables) | 12 Months Ended |
Dec. 31, 2023 | |
Notes Tables | |
Long-Lived Assets by Geographic Areas [Table Text Block] | December 31, 2023 Long-Lived Assets Total Assets US 29 % 46 % EMEA 68 % 52 % Asia 3 % 2 % Total 100 % 100 % December 31, 2022 Long-Lived Assets Total Assets US 35 % 72 % EMEA 62 % 27 % Asia 3 % 1 % Total 100 % 100 % |
Revenue from External Customers by Geographic Areas [Table Text Block] | Years Ended December 31, 2023 2022 US 8 % 11 % EMEA 82 % 77 % Asia 10 % 12 % Total 100 % 100 % |
Note 2 - Summary of Significa_3
Note 2 - Summary of Significant Accounting Policies (Details Textual) $ in Thousands, € in Millions | 12 Months Ended | |||
Dec. 31, 2023 USD ($) | Dec. 31, 2023 EUR (€) | Dec. 31, 2022 USD ($) | Dec. 31, 2021 USD ($) | |
Retained Earnings (Accumulated Deficit) | $ (939,368) | $ (860,935) | ||
Working Capital | 23,800 | |||
Equity, Attributable to Parent | 33,414 | 99,645 | $ 169,246 | |
Restricted Cash | 1,600 | 1,100 | ||
Debt Securities, Available-for-Sale, Realized Gain (Loss) | 0 | 0 | ||
Debt Securities, Available-for-Sale, Allowance for Credit Loss, Not to Sell before Recovery, Credit Loss, Previously Recorded, Expense (Reversal) | 0 | 0 | ||
Debt Securities, Available-for-Sale, Allowance for Credit Loss | 0 | 0 | ||
Accounts Receivable, Allowance for Credit Loss | 1,600 | 1,600 | ||
Property, Plant and Equipment, Including Purchased Software, Impairment Charges | 400 | 1,400 | ||
Proceeds From Employee Retention Tax Credit | 600 | 700 | ||
Business Combination, Contingent Consideration, Liability | $ 2,220 | $ 1,256 | ||
Period Of Service Sale Arrangement (Year) | 5 years | 5 years | ||
Period of Service Sale Arrangement at Stated Service Price (Year) | 4 years | 4 years | ||
Lessor, Operating Lease, Payment to be Received | $ 2,200 | |||
Share-Based Compensation Arrangement by Share-Based Payment Award, Fair Value Assumptions, Expected Dividend Rate | 0% | 0% | 0% | |
Number of Operating Segments | 1 | 1 | ||
Senhance Surgical Robotic System Acquisition[Member] | ||||
Business Combination, Contingent Consideration, Liability | $ 2,200 | |||
Business Combination, Contingent Consideration, Liability, Related Milestone | € | € 15 | |||
Minimum [Member] | ||||
Lessee, Operating Lease, Term of Contract (Year) | 1 year | |||
Lessee, Operating Lease, Renewal Term (Year) | 1 year | |||
Minimum [Member] | Senhance Surgical Robotic System Acquisition[Member] | ||||
Business Combination Contingent Consideration Arrangements Target Revenue | € | € 25 | |||
Maximum [Member] | ||||
Lessee, Operating Lease, Term of Contract (Year) | 10 years | |||
Lessee, Operating Lease, Renewal Term (Year) | 6 years | |||
Patents [Member] | ||||
Finite-Lived Intangible Asset, Useful Life (Year) | 10 years | |||
Developed Technology Rights [Member] | ||||
Finite-Lived Intangible Asset, Useful Life (Year) | 7 years | |||
Intellectual Property [Member] | ||||
Impairment of Intangible Assets, Finite-Lived | $ 0 | $ 0 | ||
Accounts Receivable [Member] | Customer Concentration Risk [Member] | ||||
Number of Major Customers | 1 | 1 | 1 | |
Accounts Receivable [Member] | Customer Concentration Risk [Member] | One Customer [Member] | ||||
Concentration Risk, Percentage | 83% | 83% | 69% | |
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | ||||
Number of Major Customers | 2 | 2 | 1 | |
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | One Customer [Member] | ||||
Concentration Risk, Percentage | 47% | |||
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | Customer One [Member] | ||||
Concentration Risk, Percentage | 33% | 33% | ||
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | Customer Two [Member] | ||||
Concentration Risk, Percentage | 19% | 19% | ||
Accumulated Foreign Currency Adjustment Attributable to Parent [Member] | ||||
Equity, Attributable to Parent | $ 600 | $ 1,900 |
Note 2 - Summary of Significa_4
Note 2 - Summary of Significant Accounting Policies - Estimated Useful Lives of Assets (Details) | Dec. 31, 2023 |
Operating Lease Assets [Member] | |
Property and equipment, estimated useful lives (Year) | 5 years |
Machinery, Manufacturing and Demonstration Equipment [Member] | Minimum [Member] | |
Property and equipment, estimated useful lives (Year) | 3 years |
Machinery, Manufacturing and Demonstration Equipment [Member] | Maximum [Member] | |
Property and equipment, estimated useful lives (Year) | 5 years |
Computer Equipment [Member] | |
Property and equipment, estimated useful lives (Year) | 3 years |
Furniture and Fixtures [Member] | |
Property and equipment, estimated useful lives (Year) | 5 years |
Note 3 - Revenue Recognition 1
Note 3 - Revenue Recognition 1 (Details Textual) - USD ($) $ in Millions | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Contract with Customer, Liability, Revenue Recognized | $ 0.5 | $ 0.5 |
Note 3 - Revenue Recognition 2
Note 3 - Revenue Recognition 2 (Details Textual) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2024-01-01 $ in Millions | Dec. 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 | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Revenue | $ 8,577 | $ 7,087 |
UNITED STATES | ||
Revenue | 695 | 767 |
Non-US [Member] | ||
Revenue | 7,882 | 6,320 |
Instruments and Accessories [Member] | ||
Revenue | 1,874 | 1,776 |
Instruments and Accessories [Member] | UNITED STATES | ||
Revenue | 205 | 211 |
Instruments and Accessories [Member] | Non-US [Member] | ||
Revenue | 1,669 | 1,565 |
Service [Member] | ||
Revenue | 1,052 | 1,373 |
Service [Member] | UNITED STATES | ||
Revenue | 294 | 300 |
Service [Member] | Non-US [Member] | ||
Revenue | 758 | 1,073 |
Lease [Member] | ||
Revenue | 2,006 | 1,387 |
Lease [Member] | UNITED STATES | ||
Revenue | 196 | 256 |
Lease [Member] | Non-US [Member] | ||
Revenue | 1,810 | 1,131 |
Systems [Member] | ||
Revenue | 3,645 | 2,551 |
Systems [Member] | Non-US [Member] | ||
Revenue | $ 3,645 | $ 2,551 |
Note 3 - Revenue Recognition _2
Note 3 - Revenue Recognition - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Contract assets | $ 95 | $ 116 |
Deferred revenue | $ 711 | $ 465 |
Note 4 - Cash, Cash Equivalen_3
Note 4 - Cash, Cash Equivalents, and Restricted Cash (Details Textual) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Restricted cash | $ 1,642 | $ 1,141 |
Note 4 - Cash, Cash Equivalen_4
Note 4 - Cash, Cash Equivalents, and Restricted Cash - Cash, Cash Equivalents, and Restricted Cash (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Cash | $ 4,588 | $ 3,473 |
Money market | 5,521 | 2,856 |
U.S. treasuries | 6,987 | 0 |
Total cash and cash equivalents | 17,096 | 6,329 |
Restricted cash | 1,642 | 1,141 |
Total | $ 18,738 | $ 7,470 |
Note 5 - Investments, Availab_3
Note 5 - Investments, Available-for-sale (Details Textual) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Proceeds from Sale of Debt Securities, Available-for-Sale | $ 0 | $ 0 |
Debt Securities, Available-for-Sale, Realized Gain (Loss) | $ 0 | $ 0 |
Note 5 - Investments, Availab_4
Note 5 - Investments, Available-for-sale - Summary of Investment Securities (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Amortized Cost | $ 3,981 | $ 68,564 |
Unrealized Gain | 0 | 0 |
Unrealized Loss | (10) | (504) |
Fair Value | 3,971 | 68,060 |
Short-term investments | 3,971 | 64,195 |
Long-term investments | 0 | 3,865 |
Corporate Debt Securities [Member] | ||
Amortized Cost | 3,981 | 55,201 |
Unrealized Gain | 0 | 0 |
Unrealized Loss | (10) | (447) |
Fair Value | 3,971 | 54,754 |
Short-term investments | $ 3,971 | 50,889 |
Long-term investments | 3,865 | |
Commercial Paper [Member] | ||
Amortized Cost | 12,364 | |
Unrealized Gain | 0 | |
Unrealized Loss | (49) | |
Fair Value | 12,315 | |
Short-term investments | 12,315 | |
Long-term investments | 0 | |
US Government Agencies Debt Securities [Member] | ||
Amortized Cost | 999 | |
Unrealized Gain | 0 | |
Unrealized Loss | (8) | |
Fair Value | 991 | |
Short-term investments | 991 | |
Long-term investments | $ 0 |
Note 5 - Investments, Availab_5
Note 5 - Investments, Available-for-sale - Contractual Maturities (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Mature in less than one year, amortized cost | $ 3,981 | |
Mature in less than one year, fair value | 3,971 | |
Total, amortized cost | 3,981 | $ 68,564 |
Total, fair value | $ 3,971 | $ 68,060 |
Note 6 - Fair Value - Summary o
Note 6 - Fair Value - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 | |
Cash and cash equivalents | [1] | $ 17,096 | $ 6,329 |
Restricted cash | 1,642 | 1,141 | |
Short-term investments | 3,971 | 64,195 | |
Total assets measured at fair value | 22,709 | 75,530 | |
Long-term investments | 0 | 3,865 | |
Contingent consideration | 2,220 | 1,256 | |
Warrant liabilites | 5,888 | 0 | |
Total liabilities measured at fair value | 8,108 | 1,256 | |
Fair Value, Inputs, Level 1 [Member] | |||
Cash and cash equivalents | [1] | 17,096 | 6,329 |
Restricted cash | 1,642 | 1,141 | |
Short-term investments | 0 | 0 | |
Total assets measured at fair value | 18,738 | 7,470 | |
Long-term investments | 0 | ||
Contingent consideration | 0 | 0 | |
Warrant liabilites | 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 | 3,971 | 64,195 | |
Total assets measured at fair value | 3,971 | 68,060 | |
Long-term investments | 3,865 | ||
Contingent consideration | 0 | 0 | |
Warrant liabilites | 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 | |
Total assets measured at fair value | 0 | 0 | |
Long-term investments | 0 | ||
Contingent consideration | 2,220 | 1,256 | |
Warrant liabilites | 5,888 | ||
Total liabilities measured at fair value | $ 8,108 | $ 1,256 | |
[1]Includes investments that are readily convertible to cash with original maturities of 90 days or less. |
Note 6 - Fair Value - Quantitat
Note 6 - Fair Value - Quantitative Information about Inputs and Valuation Methodologies Used for Fair Value Measurements Classification (Details) | Dec. 31, 2023 | Dec. 31, 2022 |
Measurement Input, Price Volatility [Member] | Senhance Surgical Robotic System Acquisition[Member] | Fair Value, Inputs, Level 3 [Member] | ||
Contingent consideration, measurement input | 0.35 | 0.45 |
Measurement Input, Discount Rate [Member] | Senhance Surgical Robotic System Acquisition[Member] | Fair Value, Inputs, Level 3 [Member] | ||
Contingent consideration, measurement input | 0.10 | 0.165 |
Measurement Input, Currency Exchange Rate [Member] | Senhance Surgical Robotic System Acquisition[Member] | Fair Value, Inputs, Level 3 [Member] | ||
Contingent consideration, measurement input | 1.1 | 1.07 |
Warrant [Member] | Measurement Input, Expected Dividend Rate [Member] | ||
Measurement input | 0 | |
Warrant [Member] | Measurement Input, Price Volatility [Member] | ||
Measurement input | 1.17 | |
Warrant [Member] | Measurement Input, Risk Free Interest Rate [Member] | ||
Measurement input | 0.038 | |
Warrant [Member] | Measurement Input, Expected Term [Member] | ||
Measurement input | 4.6 |
Note 6 - Fair Value - Summary_2
Note 6 - Fair Value - Summary of Change in Fair Value for Warrants and Contingent Consideration (Details) - The 2015 Senhance Acquisition [Member] - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Balance | $ 1,256 | $ 2,371 |
Change in fair value | 964 | (1,115) |
Balance | $ 2,220 | $ 1,256 |
Note 6 - Fair Value - Summary_3
Note 6 - Fair Value - Summary of Change in Fair Value for Warrants (Details) - Warrant [Member] $ in Thousands | 12 Months Ended |
Dec. 31, 2023 USD ($) | |
Balance | $ 0 |
Issuance of warrants | 7,120 |
Change in fair value | (1,232) |
Balance | $ 5,888 |
Note 7 - Inventories - Componen
Note 7 - Inventories - Components of Inventories (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Finished goods, gross | $ 9,200 | $ 11,208 |
Raw materials, gross | 2,015 | 2,545 |
Total inventories, gross | 11,215 | 13,753 |
Current Portion, gross | 7,172 | 8,284 |
Long-term portion, gross | $ 4,043 | $ 5,469 |
Note 8 - Property and Equipme_3
Note 8 - Property and Equipment (Details Textual) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Depreciation | $ 3,276 | $ 3,368 |
Note 8 - Property and Equipme_4
Note 8 - Property and Equipment - Summary of Property and Equipment (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Property, plant and equipment, gross | $ 25,046 | $ 22,222 |
Accumulated depreciation and amortization | (16,087) | (12,680) |
Property and equipment, net | 8,959 | 9,542 |
Machinery, Manufacturing and Demonstration Equipment [Member] | ||
Property, plant and equipment, gross | 9,089 | 8,450 |
Operating Lease Assets [Member] | ||
Property, plant and equipment, gross | 12,848 | 10,251 |
Computer Equipment [Member] | ||
Property, plant and equipment, gross | 603 | 600 |
Furniture and Fixtures [Member] | ||
Property, plant and equipment, gross | 715 | 831 |
Leasehold Improvements [Member] | ||
Property, plant and equipment, gross | 1,721 | 1,654 |
Construction in Progress [Member] | ||
Property, plant and equipment, gross | $ 70 | $ 436 |
Note 9 - Intellectual Propert_2
Note 9 - Intellectual Property (Details Textual) - Weighted Average [Member] | Dec. 31, 2023 | Dec. 31, 2022 |
Developed Technology Rights [Member] | ||
Finite-Lived Intangible Assets, Remaining Amortization Period (Year) | 3 years 2 months 12 days | 4 years 2 months 12 days |
Technology-Based Intangible Assets [Member] | ||
Finite-Lived Intangible Assets, Remaining Amortization Period (Year) | 3 years 3 months 18 days | 4 years 3 months 18 days |
Note 9 - Intellectual Propert_3
Note 9 - Intellectual Property - Intellectual Property (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Finite-Lived Intangible Assets, Gross | $ 69,238 | $ 69,238 |
Finite-Lived Intangible Assets, Accumulated Amortization | (67,181) | (66,801) |
Finite-Lived Intangible Assets, Foreign Currency Translation Impact | (820) | (861) |
Intellectual property, net | 1,237 | 1,576 |
Developed Technology Rights [Member] | ||
Finite-Lived Intangible Assets, Gross | 68,838 | 68,838 |
Finite-Lived Intangible Assets, Accumulated Amortization | (66,902) | (66,562) |
Finite-Lived Intangible Assets, Foreign Currency Translation Impact | (837) | (874) |
Intellectual property, net | 1,099 | 1,402 |
Technology-Based Intangible Assets [Member] | ||
Finite-Lived Intangible Assets, Gross | 400 | 400 |
Finite-Lived Intangible Assets, Accumulated Amortization | (279) | (239) |
Finite-Lived Intangible Assets, Foreign Currency Translation Impact | 17 | 13 |
Intellectual property, net | $ 138 | $ 174 |
Note 9 - Intellectual Propert_4
Note 9 - Intellectual Property - Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Total | $ 1,237 | $ 1,576 |
Intellectual Property [Member] | ||
2024 | 388 | |
2025 | 388 | |
2026 | 389 | |
2027 | 72 | |
Total | $ 1,237 | $ 1,576 |
Note 10 - Leases - Components o
Note 10 - Leases - Components of Operating Lease Expense (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
General and Administrative Expense [Member] | ||
Long-term Operating | $ 1,888 | $ 1,557 |
Note 10 - Leases -Supplemental
Note 10 - Leases -Supplemental Balance Sheet Information (Details) | Dec. 31, 2023 | Dec. 31, 2022 |
Weighted-average remaining lease term (in years) (Year) | 5 years 8 months 12 days | 6 years 9 months 18 days |
Weighted-average discount rate | 9.20% | 8.40% |
Minimum [Member] | ||
Incremental borrowing rate | 7.10% | 6.10% |
Maximum [Member] | ||
Incremental borrowing rate | 23% | 14.50% |
Note 10 - Leases - Minimum Leas
Note 10 - Leases - Minimum Lease Payments (Details) $ in Thousands | Dec. 31, 2023 USD ($) |
2024 | $ 1,491 |
2025 | 1,377 |
2026 | 1,160 |
2027 | 904 |
2028 | 834 |
Thereafter | 1,406 |
Total minimum lease payments | 7,172 |
Less: Amount of lease payments representing interest | (1,490) |
Present value of future minimum lease payments | $ 5,682 |
Note 11 - Accrued Expenses an_3
Note 11 - Accrued Expenses and Other Current Liabilities - Components of Accrued Expenses (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Consulting and other vendors | $ 461 | $ 155 |
Royalties | 9 | 24 |
Legal and professional fees | 411 | 275 |
Taxes and other assessments | 755 | 839 |
Total | $ 1,636 | $ 1,293 |
Note 12 - Income Taxes (Details
Note 12 - Income Taxes (Details Textual) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2023 | Dec. 31, 2022 | Dec. 31, 2021 | |
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount | $ 15,800 | ||
Unrecognized Tax Benefits | 715 | $ 335 | $ 141 |
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued | $ 0 | $ 0 | |
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent | 21% | 21% | |
Domestic Tax Authority [Member] | |||
Operating Loss Carryforwards | $ 446,700 | ||
Increase (Decrease) in Operating Loss Carryforwards | 253,000 | ||
Operating Loss Carryforwards, Subject to Expiration | 254,500 | ||
Operating Loss Carryforwards, Not Subject to Expiration | 192,200 | ||
Domestic Tax Authority [Member] | Research Tax Credit Carryforward [Member] | |||
Tax Credit Carryforward, Amount | 11,700 | ||
Increase (Decrease) in Tax Credit Carryforward | 8,800 | ||
State and Local Jurisdiction [Member] | |||
Operating Loss Carryforwards | 336,300 | ||
Operating Loss Carryforwards, Subject to Expiration | 323,000 | ||
Operating Loss Carryforwards, Not Subject to Expiration | 13,300 | ||
State and Local Jurisdiction [Member] | Impact of 382 Ownership Changes [Member] | |||
Increase (Decrease) in Operating Loss Carryforwards | 199,000 | ||
Foreign Tax Authority [Member] | Ministry of Economic Affairs and Finance, Italy [Member] | |||
Operating Loss Carryforwards | 25,000 | ||
Foreign Tax Authority [Member] | Luxembourg Inland Revenue [Member] | |||
Operating Loss Carryforwards, Subject to Expiration | 95,600 | ||
Foreign Tax Authority [Member] | Swiss Federal Tax Administration (FTA) [Member] | |||
Operating Loss Carryforwards, Subject to Expiration | 135,300 | ||
Foreign Tax Authority [Member] | Canada Revenue Agency [Member] | |||
Operating Loss Carryforwards, Subject to Expiration | $ 1,400 |
Note 12 - Income Taxes - Income
Note 12 - Income Taxes - Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Federal | $ 0 | $ 0 |
State | 0 | 0 |
Foreign | 196 | 239 |
Federal | 0 | 0 |
State | 0 | 0 |
Foreign | 118 | 79 |
Total income tax expense | $ 314 | $ 318 |
Note 12 - Income Taxes - Domest
Note 12 - Income Taxes - Domestic and Foreign Components of Loss from Operations (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
United States | $ (53,226) | $ (44,802) |
Foreign | (24,893) | (30,441) |
Loss before income taxes | $ (78,119) | $ (75,243) |
Note 12 - Income Taxes - Deferr
Note 12 - Income Taxes - Deferred Tax Assets (Details) - USD ($) $ in Thousands | Dec. 31, 2023 | Dec. 31, 2022 |
Stock-based compensation | $ 3,119 | $ 2,840 |
Accrued expenses and other | 2,666 | 2,538 |
Research credit carryforward | 2,859 | 1,341 |
Fixed Assets | 319 | 162 |
Net operating loss carryforwards | 93,332 | 83,908 |
Deferred Tax Assets, Gross | 112,003 | 96,092 |
Valuation Allowance | (110,511) | (94,704) |
Net deferred tax asset | 1,492 | 1,388 |
Fixed assets and other | (1,448) | (1,214) |
Net deferred tax liability | (1,448) | (1,214) |
Net deferred tax asset (liability) | 44 | 174 |
Start-up Costs and Other Intangibles [Member] | ||
Capitalized costs | 644 | 921 |
Research Tax Credit Carryforward [Member] | ||
Capitalized costs | $ 9,064 | $ 4,382 |
Note 12 - Income Taxes - Unreco
Note 12 - Income Taxes - Unrecognized Tax Positions (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Beginning balance | $ 335 | $ 141 |
Gross increases for tax positions related to current periods | 328 | 194 |
Gross decreases related to 382 limitations | 52 | 0 |
Ending balance | $ 715 | $ 335 |
Note 12 - Income Taxes - Effect
Note 12 - Income Taxes - Effective Income Tax Reconciliation (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
United States federal tax at statutory rate, amount | $ (16,405) | $ (15,801) |
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent | 21% | 21% |
State taxes (net of deferred benefit), amount | $ (2,493) | $ (2,912) |
State taxes (net of deferred benefit), percent | 3.20% | 3.90% |
Nondeductible expenses, amount | $ 755 | $ 1,077 |
Nondeductible expenses, percent | (1.00%) | (1.40%) |
Change in fair market value of contingent consideration, amount | $ 244 | $ (283) |
Change in fair market value of contingent consideration, percent | (0.30%) | 0.40% |
Warrant remeasurment and financing costs, amount | $ (140) | $ 0 |
Warrant remeasurment and financing costs, percent | 0.20% | 0% |
Research & Development, amount | $ (1,898) | $ (970) |
Research & Development, percent | 2.40% | 1.30% |
Change in unrecognized tax benefits, amount | $ 380 | $ 194 |
Change in unrecognized tax benefits, percent | (0.50%) | (0.30%) |
Foreign tax rate differential, amount | $ 3,176 | $ 2,676 |
Foreign tax rate differential, percent | (4.10%) | (3.60%) |
True-up to Stock Compensation - Cancellations, amount | $ 0 | $ 49 |
True-up to Stock Compensation - Cancellations, percent | 0% | (0.10%) |
Change in enacted tax rates and other, net, amount | $ 659 | $ (96) |
Change in enacted tax rates and other, net, percent | (0.80%) | 0% |
Change in valuation allowance, amount | $ 16,036 | $ 16,384 |
Change in valuation allowance, percent | (20.50%) | (21.80%) |
Total income tax expense | $ 314 | $ 318 |
Income tax expense (benefit), percent | (0.40%) | (0.40%) |
Note 13 - Stock-based Compens_3
Note 13 - Stock-based Compensation (Details Textual) - USD ($) $ / shares in Units, $ in Millions | 1 Months Ended | 12 Months Ended | ||
Jun. 06, 2023 | Feb. 28, 2024 | Dec. 31, 2023 | Dec. 31, 2022 | |
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Vested, Weighted Average Grant Date Fair Value (in dollars per share) | $ 0.59 | $ 0.59 | ||
Performance Restricted Stock Unit [Member] | Granted in 2023 [Member] | ||||
Share-Based Compensation Arrangement by Share-Based Payment Award, Award Vesting Period | 3 years | |||
Performance Restricted Stock Unit [Member] | Granted in 2022 [Member] | ||||
Share-Based Compensation Arrangement by Share-Based Payment Award, Award Vesting Period | 3 years | |||
Performance Restricted Stock Unit [Member] | Subsequent Event [Member] | Granted in 2023 [Member] | ||||
Share-Based Compensation Arrangement by Share-Based Payment Award, Percentage of Operation Targets Achieved | 50% | |||
Share-Based Compensation Arrangement by Share-Based Payment Award, Percentage of Operation, Earned | 50% | |||
Share-Based Compensation Arrangement by Share-Based Payment Award, Percentage of Award Forfeited | 50% | |||
Share-Based Payment Arrangement, Option [Member] | ||||
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount | $ 1.6 | |||
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year) | 1 year 4 months 24 days | |||
Restricted Stock Units (RSUs) [Member] | ||||
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount | $ 4.4 | |||
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year) | 1 year 2 months 12 days | |||
Asensus Surgical, Inc. Amended and Restated Incentive Compensation Plan [Member] | ||||
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Additional Shares Authorized (in shares) | 22,000,000 | |||
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Shares Authorized (in shares) | 54,072,307 | |||
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Shares Available for Grant (in shares) | 22,185,899 | |||
Share-Based Compensation Arrangement by Share-Based Payment Award, Expiration Period (Year) | 10 years |
Note 13 - Stock-based Compens_4
Note 13 - Stock-based Compensation - Stock Option Activity (Details) - $ / shares | 12 Months Ended | |
Dec. 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) | 4 years 9 months 18 days | 5 years 3 months 21 days |
Options, Granted, Number of Shares (in shares) | 3,047,615 | |
Options, Grants in Period, Weighted Average Exercise Price (in dollars per share) | $ 0.71 | |
Options, Forfeited, Number of Shares (in shares) | (149,430) | |
Options, Forfeitures in Period, Weighted Average Exercise Price (in dollars per share) | $ 0.78 | |
Options, Cancelled, Number of Shares (in shares) | (25,173) | |
Options, Expirations in Period, Weighted Average Exercise Price (in dollars per share) | $ 27.32 | |
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) | 10,444,679 | 7,584,967 |
Options, Outstanding, Weighted Average Exercise Price (in dollars per share) | $ 3.2 | $ 4.22 |
Note 13 - Stock-based Compens_5
Note 13 - Stock-based Compensation - Stock Options Outstanding (Details) $ / shares in Units, $ in Millions | 12 Months Ended |
Dec. 31, 2023 USD ($) $ / shares shares | |
Options, Exercisable, Number of Shares (in shares) | shares | 5,726,280 |
Options, Exercisable, Weighted Average Exercise Price (in dollars per share) | $ / shares | $ 5.02 |
Options, Exercisable, Weighted Average Remaining Contractual Term (Year) | 4 years 1 month 13 days |
Options, Exercisable, Aggregate Intrinsic Value | $ | $ 0 |
Options, Vested and Expected to Vest, Exercisable, Number of Shares (in shares) | shares | 10,105,084 |
Options, Vested and Expected to Vest, Exercisable, Weighted Average Exercise Price (in dollars per share) | $ / shares | $ 3.28 |
Options, Vested and Expected to Vest, Exercisable, Weighted Average Remaining Contractual Term (Year) | 4 years 9 months 7 days |
Options, Vested or Expected to Vest, Aggregate Intrinsic Value | $ | $ 0 |
Note 13 - Stock-based Compens_6
Note 13 - Stock-based Compensation - Stock Option Valuation Assumptions (Details) | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Share-Based Compensation Arrangement by Share-Based Payment Award, Fair Value Assumptions, Expected Dividend Rate | 0% | 0% |
Minimum [Member] | ||
Expected volatility | 124% | 126% |
Risk-free interest rate | 3.53% | 1.25% |
Expected life (in years) (Year) | 3 years 9 months 18 days | 3 years 9 months 18 days |
Maximum [Member] | ||
Expected volatility | 130% | 133% |
Risk-free interest rate | 4.14% | 4.40% |
Expected life (in years) (Year) | 4 years 6 months | 4 years 6 months |
Note 13 - Stock-based Compens_7
Note 13 - Stock-based Compensation - RSU Activity (Details) - Restricted Stock Units (RSUs) [Member] | 12 Months Ended |
Dec. 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 | 8,616,931 |
Restricted stock units, Granted, weighted average grant date fair value (in dollars per share) | $ / shares | $ 0.7 |
Restricted stock units, Vested (in shares) | shares | (3,937,130) |
Restricted stock units, Vested, weighted average grant date fair value (in dollars per share) | $ / shares | $ 1.1 |
Restricted stock units, Forfeited (in shares) | shares | (837,115) |
Restricted stock units, Forfeited, weighted average grant date fair value (in dollars per share) | $ / shares | $ 0.76 |
Unvested (in shares) | shares | 12,326,177 |
Unvested December 31, 2022 (in dollars per share) | $ / shares | $ 0.81 |
Note 13 - Stock-based Compens_8
Note 13 - Stock-based Compensation - Non-cash Share-based Compensation Expense (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Share-based compensation | $ 7,918 | $ 8,416 |
Share-Based Payment Arrangement, Option [Member] | ||
Share-based compensation | 2,338 | 3,654 |
Restricted Stock Units (RSUs) [Member] | ||
Share-based compensation | 3,954 | 3,319 |
Performance Restricted Stock Unit [Member] | ||
Share-based compensation | $ 1,626 | $ 1,443 |
Note 14 - Equity Offerings (Det
Note 14 - Equity Offerings (Details Textual) - USD ($) $ / shares in Units, $ in Thousands | 12 Months Ended | ||
Jul. 27, 2023 | Dec. 31, 2023 | Mar. 18, 2022 | |
Warrants Issued in Registered Direct Offering [Member] | |||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | 23,809,524 | ||
Class of Warrant or Right, Exercise Price of Warrants or Rights | $ 0.42 | ||
Warrants and Rights Outstanding, Term | 5 years | ||
Proceeds from Issuance of Warrants | $ 7,100 | ||
Other Nonoperating Expense | $ 700 | ||
The 2022 ATM Offering [Member] | |||
Stock Offering Agreement, Maximum Share Value | $ 100,000 | ||
Stock Offering Agreement, Commission, Percent | 3% | ||
Stock Issued During Period, Shares, New Issues | 933,672 | ||
Proceeds from Issuance or Sale of Equity | $ 403 | ||
Common Stock Issued in Registered Direct Offering [Member] | |||
Stock Issued During Period, Shares, New Issues | 23,809,524 | ||
Proceeds from Issuance or Sale of Equity | $ 10,000 | ||
Proceeds from Issuance of Common Stock | 2,900 | ||
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs | $ 1,000 |
Note 14 - Equity Offerings - Su
Note 14 - Equity Offerings - Summary of Sales Under Offering (Details) - The 2022 ATM Offering [Member] $ / shares in Units, $ in Thousands | 12 Months Ended |
Dec. 31, 2023 USD ($) $ / shares shares | |
Total shares of common stock sold (in shares) | shares | 933,672 |
Average price per share (in dollars per share) | $ / shares | $ 0.43 |
Gross proceeds | $ 403 |
Commisssion paid to agents | 12 |
Net proceeds | $ 391 |
Note 15 - Basic and Diluted N_3
Note 15 - Basic and Diluted Net Loss Per Share (Details Textual) - shares shares in Thousands | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Weighted Average Number of Shares Outstanding, Diluted, Adjustment | 0 | 0 |
Note 15 - Basic and Diluted N_4
Note 15 - Basic and Diluted Net Loss Per Share - Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 47,601,356 | 17,089,534 |
Share-Based Payment Arrangement, Option [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 10,444,679 | 7,584,967 |
Restricted Stock Units (RSUs) [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 12,326,177 | 8,483,491 |
Warrant [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 24,830,500 | 1,021,076 |
Note 16 - Commitments and Con_3
Note 16 - Commitments and Contingencies - Purchase Orders Commitments (Details) - License and Supply Agreement [Member] - Senhance Surgical Robotic System Acquisition[Member] $ in Thousands | Dec. 31, 2023 USD ($) |
2024 | $ 3,263 |
2025 | 300 |
2026 | 320 |
Total commitments | $ 3,883 |
Note 17 - Segments and Geogra_3
Note 17 - Segments and Geographic Areas (Details Textual) | 12 Months Ended |
Dec. 31, 2023 | |
Number of Operating Segments | 1 |
Note 17 - Segments and Geogra_4
Note 17 - Segments and Geographic Areas - Consolidated Assets and Long Lived Assets by Geographic Area (Details) - Geographic Concentration Risk [Member] | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
UNITED STATES | Long-lived Assets [Member] | ||
Percentage | 29% | 35% |
UNITED STATES | Assets, Total [Member] | ||
Percentage | 46% | 72% |
Europe, Middle East, and Africa [Member] | Long-lived Assets [Member] | ||
Percentage | 68% | 62% |
Europe, Middle East, and Africa [Member] | Assets, Total [Member] | ||
Percentage | 52% | 27% |
Asia [Member] | Long-lived Assets [Member] | ||
Percentage | 3% | 3% |
Asia [Member] | Assets, Total [Member] | ||
Percentage | 2% | 1% |
All Countries [Member] | Long-lived Assets [Member] | ||
Percentage | 100% | 100% |
All Countries [Member] | Assets, Total [Member] | ||
Percentage | 100% | 100% |
Note 17 - Segments and Geogra_5
Note 17 - Segments and Geographic Areas - Sales by Geographic Area (Details) - Revenue Benchmark [Member] - Geographic Concentration Risk [Member] | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
UNITED STATES | ||
Concentration risk, percent | 8% | 11% |
EMEA [Member] | ||
Concentration risk, percent | 82% | 77% |
Asia [Member] | ||
Concentration risk, percent | 10% | 12% |
All Countries [Member] | ||
Concentration risk, percent | 100% | 100% |
Note 18 - Related Party Trans_2
Note 18 - Related Party Transactions (Details Textual) - USD ($) $ in Millions | 12 Months Ended | |
Dec. 31, 2023 | Dec. 31, 2022 | |
Synchrony Labs, LLC [Member] | Preclinical Evaluation of the LUNA Surgical System [Member] | ||
Related Party Transaction, Expenses from Transactions with Related Party (Deprecated 2023) | $ 0.1 | |
Asensus Surgical Europe S.à.R.L [Member] | 1 Med S.A. [Member] | Service Supply Agreement [Member] | ||
Related Party Transaction, Expenses from Transactions with Related Party (Deprecated 2023) | $ 0.1 | $ 0.3 |
Synchrony Labs, LLC [Member] | Director of Asensus [Member] | ||
Ownership Percentage | 10% |