0000876378-19-000008 | 10-Q | XBRL Viewer

Warrants (Tables)

6 Months Ended

Jun. 30, 2019

Warrants and Rights Note Disclosure [Abstract]

The following table summarizes the change in warrants for the six months ended June 30, 2019:



	Number of Warrants		Weighted Average Exercise Price	Weighted Average Remaining Contractual Life (in years)	Weighted Average Fair Value
Outstanding at December 31, 2018	4,329,437		1.03	3.7	0.26
Exercised	(200,000	)	1.00	8.2	—
Expired	—		—	—	—
Outstanding at June 30, 2019	4,129,437		1.03	3.0	0.22

Consolidated Statements of Operations and Comprehensive Loss - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Income Statement [Abstract]
Revenue	$ 3,639	$ 6,389	$ 5,820	$ 11,156
Cost of revenue	3,936	3,732	6,403	6,287
Gross (loss) profit	(297)	2,657	(583)	4,869
Operating Expenses (Income)
Research and development	6,295	5,281	11,950	10,546
Sales and marketing	7,868	6,046	15,542	12,016
General and administrative	4,489	3,627	9,049	6,303
Amortization of intangible assets	2,585	2,743	5,196	5,570
Change in fair value of contingent consideration	960	812	1,958	1,439
Acquisition related costs	0	0	45	0
Loss (gain) from sale of SurgiBot assets, net	0	37	97	(11,959)
Total Operating Expenses	22,197	18,546	43,837	23,915
Operating Loss	(22,494)	(15,889)	(44,420)	(19,046)
Other Income (Expense)
Change in fair value of warrant liabilities	2,528	(17,507)	2,422	(15,678)
Interest income	178	320	496	590
Interest expense	(1,061)	(2,056)	(2,177)	(2,712)
Other (expense) income	(191)	1	(496)	(57)
Total Other Income (Expense), net	1,454	(19,242)	245	(17,857)
Loss before income taxes	(21,040)	(35,131)	(44,175)	(36,903)
Income tax benefit	869	883	1,479	1,773
Net loss	(20,171)	(34,248)	(42,696)	(35,130)
Comprehensive loss
Foreign currency translation gain (loss)	1,240	(4,398)	(709)	(2,090)
Comprehensive loss	$ (18,931)	$ (38,646)	$ (43,405)	$ (37,220)
Net loss per common share:
Basic (in dollars per share)	$ (0.09)	$ (0.17)	$ (0.20)	$ (0.17)
Diluted (in dollars per share)	$ (0.10)	$ (0.17)	$ (0.21)	$ (0.17)
Weighted average number of shares used in computing net loss per common share:
Basic (in shares)	217,471	204,504	217,135	202,214
Diluted (in shares)	218,579	204,504	218,579	202,214

Consolidated Statements of Shareholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-in Capital	Accumulated Deficit	Accumulated Other Comprehensive (Loss) Income
Balance (in shares) at Dec. 31, 2017		199,282
Balance at Dec. 31, 2017	$ 178,848	$ 199		$ 621,261	$ (447,640)	$ 5,028
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation	1,834			1,834
Exercise of stock options and warrants (in shares)		1,038
Exercise of stock options and warrants	2,228	$ 1		2,227
Award of restricted stock units (in shares)		367
Return of common stock to pay withholding taxes on restricted stock (in shares)			174
Cancellation of treasury stock (in shares)			(174)
Cumulative effect of change in accounting principle	11				11
Other comprehensive (loss) income	2,308					2,308
Issuance of common stock and warrants, net of issuance costs	11			11
Issuance of common stock related to sale of SurgiBot assets (in shares)		1,286
Issuance of common stock related to sale of SurgiBot assets	3,000	$ 1		2,999
Net loss	(882)				(882)
Balance (in shares) at Mar. 31, 2018		201,973
Balance at Mar. 31, 2018	187,358	$ 201		628,332	(448,511)	7,336
Balance (in shares) at Dec. 31, 2017		199,282
Balance at Dec. 31, 2017	178,848	$ 199		621,261	(447,640)	5,028
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	(35,130)
Balance (in shares) at Jun. 30, 2018		207,712
Balance at Jun. 30, 2018	165,718	$ 207		645,332	(482,759)	2,938
Balance (in shares) at Mar. 31, 2018		201,973
Balance at Mar. 31, 2018	187,358	$ 201		628,332	(448,511)	7,336
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation	2,370			2,370
Exercise of stock options and warrants (in shares)		5,735
Exercise of stock options and warrants	14,645	$ 6		14,639
Award of restricted stock units (in shares)		4
Return of common stock to pay withholding taxes on restricted stock (in shares)			2
Cancellation of treasury stock (in shares)			(2)
Other comprehensive (loss) income	(4,398)					(4,398)
Issuance of common stock and warrants, net of issuance costs	(9)			(9)
Net loss	(34,248)				(34,248)
Balance (in shares) at Jun. 30, 2018		207,712
Balance at Jun. 30, 2018	165,718	$ 207		645,332	(482,759)	2,938
Balance (in shares) at Dec. 31, 2018		216,346
Balance at Dec. 31, 2018	168,521	$ 216		676,373	(509,406)	1,338
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation	2,981			2,981
Exercise of stock options and warrants (in shares)		159
Exercise of stock options and warrants	236	$ 0		236
Award of restricted stock units (in shares)		613
Award of restricted stock units	1	$ 1
Return of common stock to pay withholding taxes on restricted stock (in shares)			194
Return of common stock to pay withholding taxes on restricted stock	(499)			(499)
Cancellation of treasury stock (in shares)			(194)
Cumulative effect of change in accounting principle	0			(7)	7
Other comprehensive (loss) income	(1,949)					(1,949)
Net loss	(22,525)				(22,525)
Balance (in shares) at Mar. 31, 2019		217,118
Balance at Mar. 31, 2019	146,766	$ 217		679,084	(531,924)	(611)
Balance (in shares) at Dec. 31, 2018		216,346
Balance at Dec. 31, 2018	168,521	$ 216		676,373	(509,406)	1,338
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	(42,696)
Balance (in shares) at Jun. 30, 2019		217,625
Balance at Jun. 30, 2019	131,487	$ 217		682,736	(552,095)	629
Balance (in shares) at Mar. 31, 2019		217,118
Balance at Mar. 31, 2019	146,766	$ 217		679,084	(531,924)	(611)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation	3,355			3,355
Exercise of stock options and warrants (in shares)		324
Exercise of stock options and warrants	297			297
Award of restricted stock units (in shares)		183
Award of restricted stock units	0
Other comprehensive (loss) income	1,240					1,240
Net loss	(20,171)				(20,171)
Balance (in shares) at Jun. 30, 2019		217,625
Balance at Jun. 30, 2019	$ 131,487	$ 217		$ 682,736	$ (552,095)	$ 629

Inventories - Schedule of Inventory (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Inventory Disclosure [Abstract]
Finished goods	$ 9,586	$ 5,439
Raw materials	10,505	5,502
Total inventories	$ 20,091	$ 10,941

Summary of Significant Accounting Policies

6 Months Ended

Jun. 30, 2019

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Basis of Presentation

The Company has prepared the accompanying unaudited interim condensed consolidated financial statements in accordance with the instructions to Form 10-Q and the standards of accounting measurement set forth in the Interim Reporting Topic of the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”). Consequently, the Company has not necessarily included in this Form 10-Q all information and footnotes required for audited financial statements. In the opinion of the Company’s management, the accompanying unaudited condensed consolidated financial statements in this Form 10-Q contain all adjustments, consisting only of normal recurring adjustments, except as otherwise indicated, necessary for a fair statement of its financial position, results of operations, and cash flows of the Company for all periods presented. The results reported in these condensed consolidated financial statements should not be regarded as necessarily indicative of results that may be expected for any subsequent period or for the entire year. These unaudited condensed consolidated financial statements and notes thereto should be read in conjunction with the Company’s audited financial statements and the notes thereto included in the Fiscal 2018 Form 10-K. Certain information and footnote disclosures normally included in the annual financial statements prepared in accordance with generally accepted accounting principles in the U.S. (“U.S. GAAP”) have been condensed or omitted in the accompanying interim consolidated financial statements. The year-end condensed consolidated balance sheet data was derived from audited financial statements, but does not include all disclosures required by U.S. GAAP. The accompanying Consolidated Financial Statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, SafeStitch LLC, TransEnterix Surgical, Inc., TransEnterix International, Inc., TransEnterix Italia S.r.l., TransEnterix Europe S.à.R.L; TransEnterix Asia Pte. Ltd.; TransEnterix Taiwan Ltd.; TransEnterix Japan KK; TransEnterix Israel Ltd. and TransEnterix Netherlands B.V. All material inter-company accounts and transactions have been eliminated in consolidation.

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 $552.1 million as of June 30, 2019, and has working capital of $46.8 million as of June 30, 2019. 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. In order to continue as a going concern, the Company will need, among other things, additional capital resources.

Traditionally, the Company has raised additional capital through equity offerings. Management's plan to obtain such 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. In addition, the Company may consider fundamental business combination transactions. If the Company is unable to obtain adequate capital through one of these methods, or if expected capital from existing agreements is not received when due, or at all, it would need to reduce its sales and marketing and administrative expenses and delay research and development projects, including the purchase of equipment and supplies, until it is able to obtain sufficient funds. If such sufficient funds are not received on a timely basis, the Company would then need to pursue a plan to license or sell its assets, seek to be acquired by another entity, cease operations and/or seek bankruptcy protection. 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 future financial covenants on its existing debt, 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.

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 identifiable intangible assets and goodwill, contingent consideration, warrant liabilities, stock compensation expense, revenue recognition, accounts receivable reserves, excess and obsolete inventory reserves, and deferred tax asset valuation allowances.

Cash and Cash Equivalents and Restricted Cash

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 at June 30, 2019 includes $0.7 million in cash accounts held as collateral primarily under the terms of an office operating lease, credit cards and automobile leases. Restricted cash at December 31, 2018 includes $0.6 million in cash accounts held as collateral primarily under the terms of an office operating lease, credit cards and automobile leases.

Short-term Investments

Short-term investments are considered to be “held-to-maturity” and are carried at amortized cost using the effective interest method. As of June 30, 2019 and December 31, 2018, short-term investments consisted of $10.0 million and $51.8 million, respectively, in U.S. government securities, all of which mature in less than a year.

The Company reassesses the appropriateness of the classification of its investments at the end of each reporting period. The Company has determined that its debt securities should be classified as held-to-maturity as of June 30, 2019 and December 31, 2018. This classification was based upon management’s determination that it has the positive intent and ability to hold the securities until their maturity dates, as the investments mature within six months and the underlying cash invested in these securities is not required prior to the investments maturity. Due to the short-term maturities of these instruments, the amortized cost approximates the related fair values, which are based on level 1 inputs as defined in Note 5. As of June 30, 2019 and December 31, 2018, the gross holding gains and losses were immaterial.

The Company reviews its short-term investments for other-than-temporary impairment if the cost exceeds the fair value. No such impairment was recorded as of June 30, 2019 or December 31, 2018.

Concentrations and Credit Risk

The Company’s principal financial instruments subject to potential concentration of credit risk are cash and cash equivalents, including amounts held in money market accounts and short-term investments. 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. Our oversees cash deposits follows the EU Directive, whereby €0.1 million is deemed an appropriate level of protection, with deposits covered per depositor per bank. The Company’s short-term investments consist of U.S. government securities. The Company has not experienced losses on these accounts, and management believes that the Company is not exposed to significant risks on such accounts.

The Company’s accounts receivable are derived from sales to customers located throughout the world. The Company evaluates its customers’ financial condition and, generally, requires no collateral from its customers. The Company provides reserves for potential credit losses but has not experienced significant losses to date. The Company had five customers who constituted 93% of the Company’s net accounts receivable at June 30, 2019. The Company had five customers who constituted 89% of the Company’s net accounts receivable at December 31, 2018. The Company had five customers who accounted for 91% of sales for the three months ended June 30, 2019 and three different customers who accounted for 96% of sales for the three months ended June 30, 2018. For the six months ended June 30, 2019, the Company had two customers who accounted for 76% of the Company's net revenue, while for the six months ended June 30, 2018, the Company had five different customers who accounted for 94% of the Company's net revenue.

Accounts Receivable

Accounts receivable are recorded at net realizable value, which includes an allowance for estimated uncollectable accounts. The allowance for uncollectible accounts was determined based on historical collection experience.

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 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.

Identifiable Intangible Assets and Goodwill

Identifiable intangible assets are recorded at cost, or when acquired as part of a business acquisition, at estimated fair value. Certain intangible assets are amortized over 5 to 10 years. Similar to tangible personal property and equipment, the Company periodically evaluates identifiable intangible assets for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable.

Intellectual property consists of purchased patent rights and developed technology acquired as part of a business acquisition. Amortization of the patent rights is recorded using the straight-line method over the estimated useful life of the patents of 10 years. Amortization of the developed technology is recorded using the straight-line method over the estimated useful life of 5 to 7 years. This method approximates the period over which the Company expects to receive the benefit from these assets. No impairment existed at June 30, 2019 or December 31, 2018.

Indefinite-lived intangible assets, such as goodwill, are not amortized. The Company tests the carrying amounts of goodwill for recoverability on an annual basis at December 31 or when events or changes in circumstances indicate evidence that a potential impairment exists, using a fair value based test. The Company continues to operate in one segment, which is considered to be the sole reporting unit and therefore, goodwill is tested for impairment at the enterprise level. No impairment existed at June 30, 2019 or December 31, 2018.

In-Process Research and Development

In-process research and development (“IPR&D”) assets represent the fair value assigned to technologies that were acquired, which at the time of acquisition have not reached technological feasibility and have no alternative future use. IPR&D assets are considered to be indefinite-lived until the completion or abandonment of the associated research and development projects. During the period that the IPR&D assets are considered indefinite-lived, they are tested for impairment on an annual basis, or more frequently if the Company becomes aware of any events occurring or changes in circumstances that indicate that the fair value of the IPR&D assets are less than their carrying amounts. If and when development is complete, which generally occurs upon regulatory approval, and the Company is able to commercialize products associated with the IPR&D assets, these assets are then deemed definite-lived and are amortized based on their estimated useful lives at that point in time. If development is terminated or abandoned, the Company may have a full or partial impairment charge related to the IPR&D assets, calculated as the excess of carrying value of the IPR&D assets over fair value.

The IPR&D for the Senhance System was acquired on September 21, 2015. On October 13, 2017, upon receiving FDA clearance and the ability to commercialize the products associated with the IPR&D assets, the assets were deemed definite-lived, reclassified to intellectual property and are now amortized based on their estimated useful lives.

The IPR&D from MST was acquired on October 31, 2018.

Property and Equipment

Property and equipment consists primarily of machinery, manufacturing equipment, demonstration equipment, computer equipment, furniture, and leasehold improvements, which are recorded at cost.

Depreciation is recorded using the straight-line method over the estimated useful lives of the assets as follows:



Machinery, manufacturing and demonstration equipment	3-5 years
Computer equipment	3 years
Furniture	5 years
Leasehold improvements	Lesser of lease term or 3 to 10 years

Upon retirement or sale, the cost of assets disposed of and the related accumulated depreciation and amortization are removed from the accounts and any resulting gain or loss is credited or charged to operations. Repairs and maintenance costs are expensed as incurred.

Impairment of Long-Lived Assets

The Company reviews its long-lived 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.

The Company’s estimates of anticipated cash flows and the remaining estimated useful lives of long-lived assets could be reduced in the future, resulting in a reduction to the carrying amount of long-lived assets.

Contingent Consideration

Contingent consideration is recorded as a liability and is the estimate of the fair value of potential milestone payments related to business acquisitions. Contingent consideration is measured at fair value using a discounted cash flow model utilizing significant unobservable inputs including the probability of achieving each of the potential milestones, future Euro-to-USD exchange rates, and an estimated discount rate associated with the risks of the expected cash flows attributable to the various milestones. Significant increases or decreases in any of the probabilities of success or changes in expected timelines for 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) income.

Warrant Liabilities

The Company’s Series B Warrants (see Note 14) are measured at fair value using a simulation 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 volatility, holding cost and the risk-free interest rate for the term of the warrant (see Note 5). 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) income. The selection of the appropriate valuation model and the inputs and assumptions that are required to determine the valuation requires significant judgment and requires management to make estimates and assumptions that affect the reported amount of the related liability and reported amounts of the change in fair value. Actual results could differ from those estimates, and changes in these estimates are recorded when known. As the warrant liability is required to be measured at fair value at each reporting date, it is reasonably possible that these estimates and assumptions could change in the near term.

Translation of Foreign Currencies

The functional currency of the Company’s operational foreign subsidiaries is predominately the Euro. The assets and liabilities of the Company’s foreign subsidiaries are translated into U.S. dollars at exchange rates in effect at the balance sheet date. Income and expense items are translated at the average exchange rates prevailing during the period. The cumulative translation effect for a subsidiary using a functional currency other than the U.S. dollar is included in accumulated other comprehensive income or loss as a separate component of stockholders’ equity.

The Company’s intercompany accounts are denominated in the functional currency of the foreign subsidiary. Gains and losses resulting from the remeasurement of intercompany receivables that the Company considers to be of a long-term investment nature are recorded as a cumulative translation adjustment in accumulated other comprehensive income or loss as a separate component of stockholders’ equity, while gains and losses resulting from the remeasurement of intercompany receivables from a foreign subsidiary for which the Company anticipates settlement in the foreseeable future are recorded in the 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 six months ended June 30, 2019 and 2018 were not significant.

Business Acquisitions

Business acquisitions are accounted for using the acquisition method of accounting in accordance with ASC 805, “Business Combinations.” ASC 805 requires, among other things, that assets acquired and liabilities assumed be recognized at their fair values, as determined in accordance with ASC 820, “Fair Value Measurements,” as of the acquisition date. For certain assets and liabilities, book value approximates fair value. In addition, ASC 805 establishes that consideration transferred be measured at the closing date of the acquisition at the then-current market price. Under ASC 805, acquisition-related costs (i.e., advisory, legal, valuation and other professional fees) and certain acquisition-related restructuring charges impacting the target company are expensed in the period in which the costs are incurred. The application of the acquisition method of accounting requires the Company to make estimates and assumptions related to the estimated fair values of net assets acquired.

Significant judgments are used during this process, particularly with respect to intangible assets. Therefore, the purchase price allocation to intangible assets and goodwill has a significant impact on future operating results.

Risk and Uncertainties

The Company is subject to a number of 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; the liquidity and capital resources of its partners; its ability to successfully develop, clinically test and commercialize its products; the timing and

outcome of the regulatory review process for its products; changes in the health care and 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 concern; competition in the market for robotic surgical devices; and its ability to identify and pursue development of additional products.

Revenue Recognition

The Company adopted ASC Topic 606, Revenue from Contracts with Customers (the “New Revenue Standard”), on January 1, 2018. The Company’s revenue consists of product revenue resulting from the sale of systems, system components, instruments and accessories, and service revenue. The Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and the customer, the rights of the parties are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company's revenues are measured based on consideration specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government authorities.

The Company’s system sale arrangements generally contain multiple products and services. For these bundled 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 bundled package, and if a customer can benefit from it on its own or with other resources that are readily available to the customer. The Company’s system sale arrangements include a combination of the following performance obligations: system(s), system components, instruments, accessories, and system service. The Company’s system sale arrangements generally include a five years period of service. The first year of service is generally free and included in the system sale arrangement and the remaining four years are generally included at a stated service price. The Company considers the service terms in the arrangements that are legally enforceable to be performance obligations. Other than service, the Company generally satisfies all of the performance obligations up-front. System components, system accessories, instruments, accessories, and service are also sold on a standalone basis.

The Company recognizes revenues as the performance obligations are satisfied by transferring control of the product or service to a customer. The Company generally recognizes revenue for the performance obligations as follows:

•

System sales. For systems and system components sold directly to end customers, revenue is recognized when the Company transfers control to the customer, which is generally at the point when acceptance occurs that indicates customer acknowledgment of delivery or installation, depending on the terms of the arrangement. For systems sold through distributors, for which distributors are responsible for installation, revenue is recognized generally at the time of shipment. The Company’s system arrangements generally do not provide a right of return. The 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. Accessory products include sterile drapes used to help ensure a sterile field during surgery, vision products such as replacement endoscopes, camera heads, light guides, and other items that facilitate use of the Senhance System.


•	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.

For multiple-element arrangements, revenue is allocated to each performance obligation based on its relative standalone selling price. Standalone selling prices are based on observable prices at which the Company separately sells the products or services. Due to limited sales to date, standalone selling prices are not directly observable. The Company estimates the standalone selling price using the market assessment approach considering market conditions and entity-specific factors including, but not limited to, features and functionality of the products and services, geographies, type of customer, and market conditions. The Company regularly reviews standalone selling prices and updates these estimates if necessary.

The following table presents revenue disaggregated by type and geography:



	Three Months Ended				Six Months Ended
	2019		2018		2019		2018
	(in thousands) (unaudited)
U.S.
Systems	$	—	$	875	$	—	$	875
Instruments and accessories	25		409		25		409
Services	127		28		260		49
Total U.S. revenue	152		1,312		285		1,333
Outside of U.S. ("OUS")
Systems	2,737		3,782		4,024		7,236
Instruments and accessories	535		1,101		1,081		2,212
Services	215		194		430		375
Total OUS revenue	3,487		5,077		5,535		9,823
Total
Systems	2,737		4,657		4,024		8,111
Instruments and accessories	560		1,510		1,106		2,621
Services	342		222		690		424
Total revenue	$	3,639	$	6,389	$	5,820	$	11,156

The Company recognizes sales by geographic area based on the country in which the customer is based.

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 was approximately $3.8 million as of June 30, 2019.

The Company invoices its customers based on the billing schedules in its sales arrangements. Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative selling price of the related performance obligations and the contractual billing terms in the arrangements. Contract assets are included in accounts receivable and totaled $0.2 million and $0.1 million as of June 30, 2019 and 2018, respectively. 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 six months ended June 30, 2019 and 2018, that was included in the deferred revenue balance at the beginning of each reporting period was $0.7 million and $0.2 million, respectively. Revenue for the three months ended June 30, 2019 also included $1.3 million from a system sold in 2017 for which revenue was deferred until its first clinical use, which occurred in the second quarter of 2019.

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.

Cost of Revenue

Cost of revenue consists of contract manufacturing, materials, labor and manufacturing overhead incurred internally to produce the products. Shipping and handling costs incurred by the Company are included in cost of revenue. During the six months ended June 30, 2019, the Company recorded $0.8 million charge for inventory obsolescence related to certain system components.

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 follows ASC 718 “Stock Compensation”, which provides guidance in accounting for share-based awards exchanged for services rendered and requires companies to expense the estimated fair value of these awards over the requisite service period. The Company recognizes compensation expense for stock-based awards based on estimated fair values on the date of grant for awards. The Company uses the Black-Scholes-Merton option pricing model to determine the fair value of stock options. The fair value of restricted stock units is determined by the market price of the Company’s common stock on the date of grant. The expense associated with stock-based compensation is recognized on a straight-line basis over the requisite service period of each award.

The Company records as expense the fair value of stock-based compensation awards, including stock options and restricted stock units. Compensation expense for stock-based compensation was approximately $6.3 million and $4.2 million for the six months ended June 30, 2019 and 2018, respectively.

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.

On December 22, 2017, the Tax Cuts and Jobs Act (“Tax Legislation”) was enacted into law, which reduced the U.S. federal corporate income tax rate to 21% for tax years beginning after December 31, 2017. As a result of the newly enacted tax rate, the Company adjusted its U.S. deferred tax assets as of December 31, 2017, by applying the new 21% rate, which resulted in a decrease to the deferred tax assets and a corresponding decrease to the valuation allowance of approximately $36.1 million, resulting in no impact to the consolidated statement of operations.

The Tax Legislation also implements a territorial tax system. Under the territorial tax system, in general, the Company's foreign earnings will no longer be subject to tax in the U.S. As part of transition to the territorial tax system the Tax Legislation includes a mandatory deemed repatriation of all undistributed foreign earnings that are subject to a U.S. income tax. The Company has determined that the deemed repatriation applicable to the year ending December 31, 2017 does not result in an additional U.S. income tax liability as it has no undistributed foreign earnings.

The FASB Staff Q&A, Topic 740, No. 5, Accounting for Global Intangible Low-Taxed Income (“GILTI”), states that an entity can make an accounting policy election to either recognize deferred taxes for temporary basis differences expected to reverse as GILTI in future years or to provide for the tax expense related to GILTI in the year the tax is incurred as a period expense only. The Company has elected to account for GILTI as a period expense in the year the tax is incurred.

Comprehensive (Loss) Income

Comprehensive (loss) income is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources.

Segments

The Company operates in one business segment—the research, development and sale of medical device robotics to improve minimally invasive surgery. The Company’s chief operating decision maker (determined to be the Chief Executive Officer) does not manage any part of the Company separately, and the allocation of resources and assessment of performance are based on the Company’s consolidated operating results. Approximately 42% and 54% of the Company’s total consolidated assets are located within the U.S. as of June 30, 2019 and December 31, 2018, respectively. The remaining assets are mostly located in Europe and are primarily related to the Company’s facility in Italy, and include goodwill, intellectual property, in-process research and development, other current assets, property and equipment, cash, accounts receivable and inventory of $118.4 million and $111.0 million at June 30, 2019 and December 31, 2018, respectively. Total assets outside of the U.S. excluding goodwill amounted to 43% and 34% of total consolidated assets at June 30, 2019 and December 31, 2018, respectively. The Company recognizes sales by geographic area based on the country in which the customer is based. For the six months ended June 30, 2019 and 2018, 5% and 12%, respectively, of net revenue were generated in the United States; 95% and 88%, respectively, were generated in Europe and Asia.

Impact of Recently Issued Accounting Standards

In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework—Changes to the Disclosure Requirements for Fair Value Measurement. This ASU eliminates, adds and modifies certain disclosure requirements for fair value measurements as part of its disclosure framework project. The standard is effective for all entities for financial statements issued for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years. Early adoption is permitted. The Company is currently assessing this ASU and has not yet determined the impact ASU 2018-13 may have on its consolidated financial statements.

In June 2018, the FASB issued ASU 2018-07, Compensation-Stock Compensation (Topic 718), Improvements to Nonemployee Share-based Payments. This ASU expands the scope of Topic 718 to include share-based payment transactions for acquiring goods and services from non-employees. The Company adopted ASU 2018-07 on January 1, 2019, whereby the accounting for share-based payments for non-employees and employees will be substantially the same. The adoption of ASU 2018-7 did not have a material impact on the consolidated financial statements.

In July 2017, the FASB issued ASU 2017-11, Earnings Per Share (Topic 260); Distinguishing Liabilities from Equity (Topic 480); Derivatives and Hedging (Topic 815): (Part I) Accounting for Certain Financial Instruments with Down Round Features, (Part II) Replacement of the Indefinite Deferral for Mandatorily Redeemable Financial Instruments of Certain Nonpublic Entities and Certain Mandatorily Redeemable Noncontrolling Interests with a Scope Exception. The amendments in this update are intended to simplify the accounting for certain equity-linked financial instruments and embedded features with down round features that result in the strike price being reduced on the basis of the pricing of future equity offerings. Under the new guidance, a down round feature will no longer need to be considered when determining whether certain financial instruments or embedded features should be classified as liabilities or equity instruments. That is, a down round feature will no longer preclude equity classification when assessing whether an instrument or embedded feature is indexed to an entity's own stock. In addition, the amendments clarify existing disclosure requirements for equity-classified instruments. These amendments are effective for fiscal years, and interim periods within those years, beginning after December 15, 2018, with early adoption permitted. The adoption of this ASU did not have a material impact on the consolidated financial statements.

In February 2016, the FASB issued ASU 2016-02, Leases (Topic (842), which establishes a right-of-use (ROU) model that requires a lessee to record a ROU asset and a lease liability on the balance sheet for most leases. In July 2018, the FASB issued ASU 2018-11, Leases (Topic 842), Targeted Improvements, which amends the guidance to add a method of adoption whereby the issuer may elect to recognize a cumulative effect adjustment at the beginning of the period of adoption. ASU 2018-11 Leases (Topic 842), Targeted Improvements, does not require comparative period financial information to be adjusted. Leases will be classified as either finance or operating, with classification affecting the pattern of expense recognition in the income statement.

ASU 2016-02 defines a lease as a contract, or part of a contract, that conveys the right to control the use of identified property, plant or equipment for a period of time in exchange for consideration. To determine whether a contract conveys the right to control the use of the identified asset for a period of time, the customer has to have both (i)the right to obtain substantially all of the economic benefits from the use of the identified asset and (ii)the right to direct the use of the identified asset. A contract does not contain an identified asset if the supplier has a substantive right to substitute such asset ("the leasing criteria"). As part of the adoption of ASC 842, the Company performed an assessment of the impact that the new lease recognition standard will have on its consolidated financial statements. The Company’s leases relate to office equipment, company owned vehicles and corporate offices, all of which are classified as operating leases and include fixed payments. The Company does not have any material leases, individually or in the aggregate, classified as a finance leasing arrangement under the new lease recognition standard.

On January 1, 2019, the Company adopted ASU No. 2016-02, applying the package of practical expedients to leases that commenced before the effective date whereby the Company elected to not reassess the following: (i) whether any expired or existing contracts contain leases; (ii) the lease classification for any expired or existing leases; and (iii) initial direct costs for any existing leases. The Company also elected, for all classes of underlying assets, to not separate non-lease components from lease components and instead to account for them as a single component. The Company elected to apply the transition provisions as of January 1, 2019, the date of adoption, using the effective date approach, and recorded lease ROU assets and related liabilities on its balance sheet without restating prior periods. 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. The ROU asset is included in other long-term assets on the consolidated balance sheets. The current portion of operating lease liabilities are presented within accrued liabilities while the non-current portion of operating lease liabilities are presented within other long term liabilities on the consolidated balance sheets and represents the present value of the remaining lease payments, discounted using the Company’s incremental borrowing rate, which ranges between 6.6% and 8.5% based on the terms

of the lease. The weighted average discount rate as of June 30, 2019 was 7.8% . There was no change to the Company’s consolidated statements of operations and comprehensive loss or cash flows.

The details of this adjustment are summarized below.



	Balance at December 31, 2018		Adjustments Due to ASC 842		Balance at January 1, 2019
	(unaudited) (In thousands)
Assets
Other long term assets	$	—	$	1,751	$	1,751
Liabilities and Stockholders' Equity
Accrued expenses	—		507		507
Other long term liabilities	$	—	$	1,244	$	1,244

As of June 30, 2019, the right-of-use asset totaled $2.6 million and is included within other long term assets on the consolidated balance sheet and the lease liability totaled $2.9 million, of which $1.0 million is classified as current within accrued expenses and $1.9 million is classified as non-current within other long term liabilities on the consolidated balance sheet. Operating lease costs for the three and six months ended June 30, 2019 totaled $0.4 million and $0.7 million, respectively, and is included within operating expenses in the consolidated statement of operations and comprehensive loss. The weighted average remaining lease term for operating leases as of June 30, 2019 was 3.0 years. Total cash paid for operating leases during the six month period ended June 30, 2019 was $0.7 million and is included within cash flows from operating activities within the consolidated statement of cash flows.

The following table presents the minimum lease payments as of June 30, 2019 (in thousands):



July 1, 2019 to December 31, 2019	662
January 1, 2020 to December 31, 2020	1,317
January 1, 2021 to December 31, 2021	669
January 1, 2022 to December 31, 2022	404
January 1, 2023 to December 31, 2023	194
January 1, 2024 to December 31, 2024	33
Thereafter	—
Total minimum lease payments	3,279
Less: Amount of lease payments representing interest	(352	)
Present value of future minimum lease payments	2,927

Subsequent Events - Additional Information (Detail) - USD ($)				6 Months Ended
	Aug. 09, 2019	Jul. 10, 2019	Jul. 03, 2019	Jun. 30, 2019
Subsequent Event [Line Items]
Debt covenant, market capitalization				$ 250,000,000
Subsequent Event
Subsequent Event [Line Items]
Proceeds from sale of intellectual property			$ 17,000,000.0
Debt covenant, unrestricted cash	$ 7,000,000.0
Hercules Loan Agreement \| Subsequent Event
Subsequent Event [Line Items]
Reduction of indebtedness		$ 15,000,000.0
Loan amount outstanding		$ 30,000,000.0
Initial Installment \| Subsequent Event
Subsequent Event [Line Items]
Proceeds from sale of intellectual property			5,000,000.0
Installment Two \| Subsequent Event
Subsequent Event [Line Items]
Proceeds from sale of intellectual property			12,000,000.0
Equity Portion \| Subsequent Event
Subsequent Event [Line Items]
Proceeds from sale of intellectual property			$ 30,000,000.0
Total shares of common stock sold (in shares)			15,000,000
Price per share (in dollars per share)			$ 2.00

Fair Value - Quantitative Information about Inputs and Valuation Methodologies Used for Fair Value Measurements Classification (Detail) $ / shares in Units, $ in Millions	6 Months Ended	12 Months Ended
	Jun. 30, 2019 USD ($) $ / shares	Dec. 31, 2018 USD ($) $ / shares	Apr. 28, 2017 USD ($) $ / shares
Senhance Surgical Robotic System Acquisition \| Significant Unobservable Inputs (Level 3) \| Contingent Consideration \| Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount rate	0.10
Senhance Surgical Robotic System Acquisition \| Significant Unobservable Inputs (Level 3) \| Contingent Consideration \| Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount rate	0.12
Series B Warrant
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value \| $	$ 2.2	$ 4.6	$ 6.2
Share price \| $ / shares	$ 1.36	$ 2.26	$ 0.65
Probability of additional financing	100.00%	100.00%
Series B Warrant \| Measurement Input, Expected Term
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Term	2 years 9 months 18 days	3 years 3 months 18 days	5 years
Series B Warrant \| Measurement Input, Risk Free Interest Rate
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Risk free rate	0.0171	0.0247	0.0181
Series B Warrant \| Measurement Input, Price Volatility
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Risk free rate	0.8234	0.876	0.7314

Property and Equipment

6 Months Ended

Jun. 30, 2019

Property, Plant and Equipment [Abstract]

Property and Equipment

Property and equipment consisted of the following:



	June 30, 2019			December 31, 2018
	(In thousands)
	(unaudited)
Machinery, manufacturing and demonstration equipment	$	12,565		$	12,320
Computer equipment	2,297			2,260
Furniture	638			639
Leasehold improvements	2,287			2,280
Total property and equipment	17,787			17,499
Accumulated depreciation and amortization	(12,005		)	(11,162)
Property and equipment, net	$	5,782		$	6,337

Depreciation expense was approximately $1.1 million and $1.3 million, for the six months ended June 30, 2019 and 2018, respectively.

Basic and Diluted Net Loss per Share - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2019	Jun. 30, 2018
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Incremental common shares attributable to dilutive effect of warrants (in shares)	1,100,000	1,400,000
Gain on warrants	$ 2.5	$ 2.4
Adjustment to weighted average outstanding common shares			0
Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)		25,884,445
Stock Warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)		1,400,352
Unvested Restricted Stock Units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)		6,191,419

Other Current Assets - Schedule of Other Current Assets (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Advances to vendors	$ 8,867	$ 7,758
Prepaid expenses	1,354	1,438
Other receivables	19	9
Total	$ 10,240	$ 9,205

Subsequent Events	6 Months Ended
Subsequent Events	Jun. 30, 2019
Subsequent Events [Abstract]
Subsequent Events	18. Subsequent Events Sale of Intellectual Property On July 3, 2019, the Company entered into an AutoLap System Sale Agreement (the “AutoLap Sale Agreement”) with GBIL. Pursuant to the AutoLap Sale Agreement, the Company sold the AutoLap laparoscopic vision system (“AutoLap”) and related assets to GBIL for $17.0 million plus an additional equity investment in the Company by GBIL of $30.0 million . The Company acquired AutoLap and its related assets from MST in October 2018. The assets include inventory, spare parts, production equipment, testing equipment and certain intellectual property specifically related to the AutoLap. In addition, at the second cosing, the Company will enter into a cross‑license agreement with GBIL to retain rights to use any AutoLap-related intellectual property sold to GBIL, and to non-exclusively license additional intellectual property to GBIL. The purchase price is to be paid in two installments. The initial $5.0 million was due on July 31, 2019 but as of the date of this filing, has not been received, and the remaining $12.0 million to be paid upon the transfer of the AutoLap and related assets. The Company cannot currently predict when the $5.0 million payment will be made. The final closing is anticipated to occur in November 2019. In addition, GBIL agreed to pay $30.0 million for the purchase of 15,000,000 shares of the Company’s common stock at $2.00 per share (the “AutoLap Shares”). Pursuant to a Subscription Agreement executed by the parties with respect to the issuance of the AutoLap Shares, upon their issuance, the AutoLap Shares will be subject to a lock-up agreement between GBIL and the Company pursuant to which GBIL agreed, subject to certain exceptions, not to sell, transfer or otherwise convey any of the AutoLap Shares for two years following the date of the second closing. The Company also agreed to register the AutoLap Shares for resale, as needed, upon the expiration of the lock-up period. Amendment to the Loan and Security Agreement In connection with the entry into the AutoLap Sale Agreement with respect to the AutoLap assets, the Company commenced discussions with the Agent, or Hercules Capital, Inc., in order to obtain the required consent of the Agent and the Lender with respect to the sale of the AutoLap assets. In connection with obtaining such consent, the Company entered into the Consent and Second Amendment to the Loan and Security Agreement on July 10, 2019 (the “Hercules Second Amendment”). Under the Hercules Second Amendment, in consideration for the consent to the sale of, and the release of the Lender’s security interest on, the AutoLap assets, the Company reduced its indebtedness under the Hercules Loan Agreement by repaying $15.0 million of the $30.0 million of outstanding indebtedness thereunder, without any prepayment penalties, amendment fee or acceleration of the end of term charges, and received adjustments to the quarterly financial covenants and related waiver conditions to reflect the decreased outstanding indebtedness. Under the Hercules Second Amendment, the applicable waiver condition for fiscal year 2019 has been changed to maintenance of unrestricted cash equal to $7.0 million. As of the date of this report, the Company is in compliance with this waiver condition.

Acquisitions - Schedule of Estimated Fair Values of Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018	Oct. 31, 2018
Business Acquisition [Line Items]
Goodwill	$ 79,904	$ 80,131
Medical Surgery Technologies Ltd.
Business Acquisition [Line Items]
Property and equipment			$ 43
In-process research and development			10,633
Goodwill	$ 9,600		9,638
Net assets acquired			$ 20,314

Commitments and Contingencies - Additional Information (Detail) € in Millions			6 Months Ended		12 Months Ended
	Dec. 30, 2016 EUR (€) shares	Sep. 21, 2015 shares	Jun. 30, 2019 USD ($)	Jun. 30, 2018 USD ($)	Dec. 31, 2018 USD ($)
Operating Leased Assets [Line Items]
Contingent consideration related to acquisition			$ (2,000,000.0)	$ (1,400,000)
Liability or related charge recorded for legal contingencies			0		$ 0
Senhance Surgical Robotic System Acquisition
Operating Leased Assets [Line Items]
Common shares issued (in shares) \| shares		15,543,413
Fair value of contingent consideration			$ 12,600,000		$ 10,600,000
Senhance Surgical Robotic System Acquisition \| Second Tranche
Operating Leased Assets [Line Items]
Contingent consideration related to acquisition \| €	€ 5.0
Common shares issued (in shares) \| shares	3,722,685
Aggregate fair market value of common stock \| €	€ 5.0

Commitments and Contingencies	6 Months Ended
Commitments and Contingencies	Jun. 30, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Contingent Consideration As discussed in Note 3, in September 2015, the Company completed the Senhance Acquisition using a combination of cash, stock and potential post-acquisition milestone payments. These milestone payments may be payable in the future, depending on the achievement of certain commercial milestones. On December 30, 2016, the Company entered into an Amendment to restructure the terms of the Second Tranche of the Cash Consideration. Under the Amendment, the Second Tranche was restructured to reduce the contingent cash consideration by €5.0 million in exchange for the issuance of 3,722,685 shares of the Company’s common stock with an aggregate fair market value of €5.0 million. As of June 30, 2019 and December 31, 2018, the fair value of the contingent consideration was $12.6 million and $10.6 million, respectively. Legal Proceedings No liability or related charge was recorded to earnings in the Company’s consolidated financial statements for legal contingencies for the six months ended June 30, 2019 or the year ended December 31, 2018.

Fair Value - Change in Fair Value for All Assets and Liabilities Using Unobservable Level 3 Inputs As Determined By Level 3 Inputs (Detail) $ in Thousands	6 Months Ended
	Jun. 30, 2019 USD ($)
Common Stock Warrants
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 4,636
Change in fair value	(2,422)
Current portion	0
Long-term portion	2,214
Ending balance	2,214
Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	10,637
Change in fair value	1,958
Current portion	74
Long-term portion	12,521
Ending balance	$ 12,595

Property and Equipment - Additional Information (Detail) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Property, Plant and Equipment [Abstract]
Depreciation	$ 1.1	$ 1.3

Goodwill, In-Process Research and Development and Intellectual Property - Additional Information (Detail) - USD ($)			3 Months Ended	6 Months Ended		12 Months Ended
	Oct. 31, 2018	Sep. 21, 2015	Jun. 30, 2019	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Goodwill And Intangible Assets [Line Items]
Goodwill			$ 79,904,000	$ 79,904,000		$ 80,131,000
Accumulated impairment of goodwill			$ 61,800,000	61,800,000		$ 61,800,000
Goodwill impairment				$ 0	$ 0
In-Process Research and Development
Goodwill And Intangible Assets [Line Items]
Discount rate	15.00%	45.00%
Intellectual Property
Goodwill And Intangible Assets [Line Items]
Discount rate		45.00%
Technology and Patents Purchased
Goodwill And Intangible Assets [Line Items]
Weighted average remaining useful life				7 years 9 months 18 days		8 years 3 months 18 days
Developed Technology
Goodwill And Intangible Assets [Line Items]
Weighted average remaining useful life			3 years 3 months 18 days			3 years 9 months 18 days
Safe Stitch Medical Inc
Goodwill And Intangible Assets [Line Items]
Goodwill			$ 93,800,000	$ 93,800,000
Senhance Surgical Robotic System Acquisition
Goodwill And Intangible Assets [Line Items]
Goodwill			38,300,000	38,300,000
Intellectual property		$ 48,500,000
Senhance Surgical Robotic System Acquisition \| In-Process Research and Development
Goodwill And Intangible Assets [Line Items]
In-process research and development		$ 17,100,000
Medical Surgery Technologies Ltd.
Goodwill And Intangible Assets [Line Items]
Goodwill	$ 9,638,000		$ 9,600,000	$ 9,600,000
Medical Surgery Technologies Ltd. \| In-Process Research and Development
Goodwill And Intangible Assets [Line Items]
In-process research and development	$ 10,600,000

Fair Value - Additional Information (Detail)	3 Months Ended		6 Months Ended
Fair Value - Additional Information (Detail)	Jun. 30, 2019 USD ($) $ / shares	Jun. 30, 2018 USD ($)	Jun. 30, 2019 USD ($) $ / shares	Jun. 30, 2018 USD ($)	Dec. 31, 2018 USD ($) $ / shares	Apr. 28, 2017 USD ($) $ / shares shares
Fair Value Measurements Disclosure [Line Items]
Transfers of assets between Level 1, Level 2, and Level 3 of the fair value hierarchy	$ 0		$ 0		$ 0
Transfers of liabilities between Level 1, Level 2, and Level 3 of the fair value hierarchy	0		0		0
Fair value of contingent consideration			2,000,000.0	$ 1,400,000
Warrants to purchase common shares (in units) \| shares						24,900,000
Offering price (in dollars per share) \| $ / shares						$ 1.00
Change in fair value of warrant liabilities	2,528,000	$ (17,507,000)	2,422,000	$ (15,678,000)
Series A Warrant
Fair Value Measurements Disclosure [Line Items]
Warrants, exercise price (in dollars per share) \| $ / shares						$ 1.00
Series A Warrant \| Black-Scholes Merton Model
Fair Value Measurements Disclosure [Line Items]
Estimated fair value of warrants						$ 2,500,000
Fair value input, share price (in dollars per share) \| $ / shares						$ 0.65
Series A Warrant \| Black-Scholes Merton Model \| Measurement Input, Expected Term
Fair Value Measurements Disclosure [Line Items]
Fair value input, term						1 year
Series A Warrant \| Black-Scholes Merton Model \| Measurement Input, Risk Free Interest Rate
Fair Value Measurements Disclosure [Line Items]
Fair value input, risk free rate						0.0107
Series A Warrant \| Black-Scholes Merton Model \| Measurement Input, Expected Dividend Payment
Fair Value Measurements Disclosure [Line Items]
Fair value input, risk free rate						0
Series A Warrant \| Black-Scholes Merton Model \| Measurement Input, Price Volatility
Fair Value Measurements Disclosure [Line Items]
Fair value input, risk free rate						0.7314
Series B Warrant
Fair Value Measurements Disclosure [Line Items]
Warrants, exercise price (in dollars per share) \| $ / shares						$ 1.00
Estimated fair value of warrants	$ 2,200,000		$ 2,200,000		$ 4,600,000	$ 6,200,000
Fair value input, share price (in dollars per share) \| $ / shares	$ 1.36		$ 1.36		$ 2.26	$ 0.65
Series B Warrant \| Measurement Input, Expected Term
Fair Value Measurements Disclosure [Line Items]
Fair value input, term	2 years 9 months 18 days		2 years 9 months 18 days		3 years 3 months 18 days	5 years
Series B Warrant \| Measurement Input, Risk Free Interest Rate
Fair Value Measurements Disclosure [Line Items]
Fair value input, risk free rate	0.0171		0.0171		0.0247	0.0181
Series B Warrant \| Measurement Input, Price Volatility
Fair Value Measurements Disclosure [Line Items]
Fair value input, risk free rate	0.8234		0.8234		0.876	0.7314
Common Stock
Fair Value Measurements Disclosure [Line Items]
Number of common stock or warrants in each unit (in shares) \| shares						1
Common Stock \| Series A Warrant
Fair Value Measurements Disclosure [Line Items]
Number of common stock or warrants in each unit (in shares) \| shares						1
Common Stock \| Series B Warrant
Fair Value Measurements Disclosure [Line Items]
Number of common stock or warrants in each unit (in shares) \| shares						0.75

Notes Payable - Additional Information (Detail) - USD ($)			6 Months Ended		12 Months Ended
	May 23, 2018	May 10, 2017	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018	Apr. 30, 2019	Oct. 23, 2018	Apr. 28, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Minimum advances available under facility						$ 5,000,000.0
Debt covenant, market capitalization			$ 250,000,000
Loss on extinguishment of notes payable			$ 0	$ (1,400,000)
Issue of warrants to purchase shares of company's common stock (in shares)								24,900,000
Notes Payable
Debt Instrument [Line Items]
Debt issuance cost									$ 300,000
Hercules Loan Agreement
Debt Instrument [Line Items]
Debt discount liability, facility fee recorded as debt discount					$ 300,000
Debt instrument, redemption price amount					700,000
Hercules Loan Agreement \| Notes Payable \| Interest Expense
Debt Instrument [Line Items]
Loss on extinguishment of notes payable					(1,400,000)
Hercules Loan Agreement \| Term Loan
Debt Instrument [Line Items]
Term loans aggregate principal amount	$ 40,000,000.0
Debt instrument amortization period	18 months
Debt discount liability, facility fee recorded as debt discount	$ 400,000
Debt issuance costs recorded as debt discount	$ 1,100,000
Prepayment fee percentage	6.95%
Percentage outstanding principal balance of term loans required to be maintained	120.00%
Percentage of maintained cash and investment property in accounts of aggregate cash of parent and subsidiaries	80.00%
Amount of investment to any future equity offering	$ 2,000,000.0
Debt instrument repayment period after interest only period	18 months
Hercules Loan Agreement \| Term Loan \| Fixed Rate and Prime Rate
Debt Instrument [Line Items]
Term loans interest rate	5.00%
Hercules Loan Agreement \| Term Loan \| Maximum
Debt Instrument [Line Items]
Term loans fixed interest rate	10.05%
Hercules Loan Agreement \| Term Loan \| First Year After Initial Funding Date
Debt Instrument [Line Items]
Prepayment fee percentage	3.00%
Hercules Loan Agreement \| Term Loan \| Second Year After Initial Funding Date
Debt Instrument [Line Items]
Prepayment fee percentage	2.00%
Hercules Loan Agreement \| Term Loan \| Second Year After Initial Funding Date And Thereafter
Debt Instrument [Line Items]
Prepayment fee percentage	1.00%
Hercules Loan Agreement \| Term Loan \| First Tranche
Debt Instrument [Line Items]
Term loans aggregate principal amount	$ 20,000,000.0
Hercules Loan Agreement \| Term Loan \| Tranche Two
Debt Instrument [Line Items]
Term loans aggregate principal amount							$ 10,000,000.0
Hercules Loan Agreement \| Term Loan \| Tranche Four
Debt Instrument [Line Items]
Term loans aggregate principal amount						$ 20,000,000.0
Loan and Security Agreement \| Term Loan
Debt Instrument [Line Items]
Debt issuance costs recorded as debt discount		$ 1,200,000
Warrant expiration period		5 years
Loan and Security Agreement \| Term Loan \| Innovatus Life Sciences Lending Fund I, LP
Debt Instrument [Line Items]
Term loans aggregate principal amount		$ 17,000,000.0
Debt instrument amortization period		24 months
Term loans fixed interest rate		11.00%
Interest only payment period		24 months
Debt instrument repayment period after interest only period		2 years
Term loans fixed interest rate, paid in-kind percentage		2.50%
Loan and Security Agreement \| Term Loan \| First Tranche
Debt Instrument [Line Items]
Debt discount liability, facility fee recorded as debt discount		$ 200,000
Warrants, exercise price (in dollars per share)		$ 1.00
Unamortized debt discount					$ 0
Loan and Security Agreement \| Term Loan \| First Tranche \| Innovatus Life Sciences Lending Fund I, LP
Debt Instrument [Line Items]
Term loans aggregate principal amount		$ 14,000,000.0
Loan and Security Agreement \| Term Loan \| First Tranche \| Maximum
Debt Instrument [Line Items]
Issue of warrants to purchase shares of company's common stock (in shares)		1,244,746

Accrued Expenses

6 Months Ended

Jun. 30, 2019

Accrued Liabilities, Current [Abstract]

Accrued Expenses

The following table presents the components of accrued expenses:



	June 30, 2019		December 31, 2018
	(In thousands)
	(unaudited)
Compensation and benefits	$	2,731	$	6,225
Consulting and other vendors	2,188		895
Other	610		539
Lease liability	1,033		—
Royalties	539		498
Legal and professional fees	311		432
Deferred rent	—		391
Taxes and other assessments	519		383
Interest	251		256
Total	$	8,182	$	9,619

Fair Value - Summary of Assets Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Assets measured at fair value
Cash and cash equivalents	$ 23,302	$ 21,061
Restricted cash	712	590
Total Assets measured at fair value	24,014	21,651
Liabilities measured at fair value
Contingent consideration	12,595	10,637
Warrant liabilities	2,214	4,636
Total liabilities measured at fair value	14,809	15,273
Quoted Prices in Active Markets for Identical Assets (Level 1)
Assets measured at fair value
Cash and cash equivalents	23,302	21,061
Restricted cash	712	590
Total Assets measured at fair value	24,014	21,651
Significant Unobservable Inputs (Level 3)
Liabilities measured at fair value
Contingent consideration	12,595	10,637
Warrant liabilities	2,214	4,636
Total liabilities measured at fair value	$ 14,809	$ 15,273

Inventories

6 Months Ended

Jun. 30, 2019

Inventory Disclosure [Abstract]

Inventories

The components of inventories are as follows:



	June 30, 2019		December 31, 2018
	(In thousands)
	(unaudited)
Finished goods	$	9,586	$	5,439
Raw materials	10,505		5,502
Total inventories	$	20,091	$	10,941

At-The-Market Offering	6 Months Ended
At-The-Market Offering	Jun. 30, 2019
Equity [Abstract]
At-The-Market Offering	At-The-Market Offering On December 28, 2018, the Company entered into an At-the-Market Equity Offering Sales Agreement (the “2018 Sales Agreement”) with Stifel, as sales agent, pursuant to which the Company can sell through Stifel, from time to time, up to $75.0 million in shares of common stock in an at-the-market offering. All sales of shares will be made pursuant to an effective shelf registration statement on Form S-3 filed with the SEC. The Company pays Stifel a commission of approximately 3% of the aggregate gross proceeds received from all sales of common stock under the 2018 Sales Agreement. Unless otherwise terminated earlier, the 2018 Sales Agreement continues until all shares available under the Sales Agreement have been sold or termination of the 2018 Sales Agreement by the Company or by Stifel. As of June 30, 2019, there were no sales of common stock under the 2018 Sales Agreement.

Other Current Assets

6 Months Ended

Jun. 30, 2019

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Other Current Assets

The following table presents the components of other current assets:



	June 30, 2019		December 31, 2018
	(In thousands)
	(unaudited)
Advances to vendors	$	8,867	$	7,758
Prepaid expenses	1,354		1,438
Other receivables	19		9
Total	$	10,240	$	9,205

Property and Equipment - Summary of Property and Equipment (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 17,787	$ 17,499
Accumulated depreciation and amortization	(12,005)	(11,162)
Property and equipment, net	5,782	6,337
Machinery, manufacturing and demonstration equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	12,565	12,320
Computer equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	2,297	2,260
Furniture
Property, Plant and Equipment [Line Items]
Property and equipment, gross	638	639
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 2,287	$ 2,280

Summary of Significant Accounting Policies - Summary of Revenue Disaggregated by Type and Geography (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Disaggregation of Revenue [Line Items]
Total revenue	$ 3,639	$ 6,389	$ 5,820	$ 11,156
Systems
Disaggregation of Revenue [Line Items]
Total revenue	2,737	4,657	4,024	8,111
Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	560	1,510	1,106	2,621
Services
Disaggregation of Revenue [Line Items]
Total revenue	342	222	690	424
U.S.
Disaggregation of Revenue [Line Items]
Total revenue	152	1,312	285	1,333
U.S. \| Systems
Disaggregation of Revenue [Line Items]
Total revenue	0	875	0	875
U.S. \| Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	25	409	25	409
U.S. \| Services
Disaggregation of Revenue [Line Items]
Total revenue	127	28	260	49
Outside of U.S.
Disaggregation of Revenue [Line Items]
Total revenue	3,487	5,077	5,535	9,823
Outside of U.S. \| Systems
Disaggregation of Revenue [Line Items]
Total revenue	2,737	3,782	4,024	7,236
Outside of U.S. \| Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	535	1,101	1,081	2,212
Outside of U.S. \| Services
Disaggregation of Revenue [Line Items]
Total revenue	$ 215	$ 194	$ 430	$ 375

Accrued Expenses (Tables)

6 Months Ended

Jun. 30, 2019

Accrued Liabilities, Current [Abstract]

Schedule of Accrued Expenses

The following table presents the components of accrued expenses:



	June 30, 2019		December 31, 2018
	(In thousands)
	(unaudited)
Compensation and benefits	$	2,731	$	6,225
Consulting and other vendors	2,188		895
Other	610		539
Lease liability	1,033		—
Royalties	539		498
Legal and professional fees	311		432
Deferred rent	—		391
Taxes and other assessments	519		383
Interest	251		256
Total	$	8,182	$	9,619

Summary of Significant Accounting Policies - Summary of Minimum Lease Payments (Detail) $ in Thousands	Jun. 30, 2019 USD ($)
Accounting Policies [Abstract]
July 1, 2019 to December 31, 2019	$ 662
January 1, 2020 to December 31, 2020	1,317
January 1, 2021 to December 31, 2021	669
January 1, 2022 to December 31, 2022	404
January 1, 2023 to December 31, 2023	194
January 1, 2024 to December 31, 2024	33
Thereafter	0
Total minimum lease payments	3,279
Less: Amount of lease payments representing interest	(352)
Present value of future minimum lease payments	$ 2,927

Cover Page - shares	6 Months Ended
Cover Page - shares	Jun. 30, 2019	Aug. 08, 2019
Cover page.
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2019
Document Transition Report	false
Entity File Number	0-19437
Entity Registrant Name	TRANSENTERIX, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	11-2962080
Entity Address, Address Line One	635 Davis Drive
Entity Address, Address Line Two	Suite 300
Entity Address, City or Town	Morrisville
Entity Address, State or Province	NC
Entity Address, Postal Zip Code	27560
City Area Code	919
Local Phone Number	765-8400
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common Stock$0.001 par value per share
Trading Symbol	TRXC
Security Exchange Name	NYSEAMER
Entity Common Stock, Shares Outstanding		217,742,389
Amendment Flag	false
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q2
Entity Central Index Key	0000876378
Current Fiscal Year End Date	--12-31

Other Current Assets (Tables)

6 Months Ended

Jun. 30, 2019

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Schedule of Other Current Assets

The following table presents the components of other current assets:



	June 30, 2019		December 31, 2018
	(In thousands)
	(unaudited)
Advances to vendors	$	8,867	$	7,758
Prepaid expenses	1,354		1,438
Other receivables	19		9
Total	$	10,240	$	9,205

Warrants

6 Months Ended

Jun. 30, 2019

Warrants and Rights Note Disclosure [Abstract]

Warrants

The following table summarizes the change in warrants for the six months ended June 30, 2019:



	Number of Warrants		Weighted Average Exercise Price	Weighted Average Remaining Contractual Life (in years)	Weighted Average Fair Value
Outstanding at December 31, 2018	4,329,437		1.03	3.7	0.26
Exercised	(200,000	)	1.00	8.2	—
Expired	—		—	—	—
Outstanding at June 30, 2019	4,129,437		1.03	3.0	0.22

Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Current Assets
Cash and cash equivalents	$ 23,302	$ 21,061
Short-term investments	9,973	51,790
Accounts receivable, net	5,669	8,560
Inventories	20,091	10,941
Interest receivable	30	26
Other current assets	10,240	9,205
Total Current Assets	69,305	101,583
Restricted cash	712	590
Property and equipment, net	5,782	6,337
Goodwill	79,904	80,131
Other long term assets	2,818	203
Total Assets	203,378	239,307
Current Liabilities
Accounts payable	7,039	4,433
Accrued expenses	8,182	9,619
Deferred revenue – current portion	897	1,733
Contingent consideration – current portion	74	72
Deferred consideration - MST Acquisition	6,310	5,962
Total Current Liabilities	22,502	21,819
Long Term Liabilities
Deferred revenue – less current portion	68	109
Contingent consideration – less current portion	12,521	10,565
Notes payable – net of debt discount	29,528	28,937
Warrant liabilities	2,214	4,636
Net deferred tax liabilities	3,164	4,720
Other long term liabilities	1,894	0
Total Liabilities	71,891	70,786
Commitments and Contingencies (Note 17)
Stockholders’ Equity
Common stock $0.001 par value, 750,000,000 shares authorized at June 30, 2019 and December 31, 2018; 217,625,492 and 216,345,984 shares issued and outstanding at June 30, 2019 and December 31, 2018, respectively	217	216
Additional paid-in capital	682,736	676,373
Accumulated deficit	(552,095)	(509,406)
Accumulated other comprehensive income	629	1,338
Total Stockholders’ Equity	131,487	168,521
Total Liabilities and Stockholders’ Equity	203,378	239,307
Intellectual Property, Net
Current Assets
Intangible assets	34,190	39,716
In-Process Research and Development
Current Assets
Intangible assets	$ 10,667	$ 10,747

Organization and Capitalization	6 Months Ended
Organization and Capitalization	Jun. 30, 2019
Accounting Policies [Abstract]
Organization and Capitalization	Organization and Capitalization TransEnterix, Inc. (the “Company”) is a medical device company that is digitizing the interface between the surgeon and the patient in laparoscopy to increase control and reduce surgical variability in today’s value-based healthcare environment. The Company is focused on the commercialization of the Senhance™ System, which digitizes laparoscopic minimally invasive surgery. The Senhance System allows for robotic precision, haptic feedback, surgeon camera control via eye sensing and improved ergonomics while offering responsible economics. The Senhance System has a CE Mark in Europe for laparoscopic abdominal and pelvic surgery, as well as limited thoracic operations excluding cardiac and vascular surgery. On October 13, 2017, the Company received 510(k) clearance from the FDA for use of the Senhance System in laparoscopic colorectal and gynecologic surgery. These indications cover 23 procedures, including benign and oncologic procedures. In May 2018, the indications for use expanded when the Company received 510(k) clearance from the FDA for use of the Senhance System in laparoscopic inguinal hernia and laparoscopic cholecystectomy (gallbladder removal) surgery for a total of 28 indicated procedures. The Senhance System is available for sale in the United States, the European Union, Japan, Taiwan and select other countries. The Senhance System is a multi-port robotic surgery system that allows multiple robotic arms to control instruments and a camera. The system features advanced technology to enable surgeons with haptic feedback and the ability to move the camera via eye movement. On October 31, 2018, the Company acquired the assets, intellectual property and highly experienced multidisciplinary personnel of MST Medical Surgical Technologies, Inc., or MST, an Israeli-based medical technology company. Through this acquisition the Company acquired MST’s AutoLap™ technology, one of the only image-guided robotic scope positioning systems with FDA clearance and CE Mark. The Company believes MST’s image analytics technology will accelerate and drive meaningful Senhance System developments, and allow the Company to expand the Senhance System to add augmented, intelligent vision capability. See Note 3 for a description of the related transaction. On July 3, 2019, the Company announced the sale of the AutoLap assets. See Note 18 for a description of the related transaction. During 2018 and early 2019, the Company successfully obtained FDA clearance and a CE Mark for 3 millimeter diameter instruments and its Senhance ultrasonic system. The 3 millimeter instruments enable the Senhance System to be used for microlaparoscopic surgeries, allowing for tiny incisions. The ultrasonic system is an advanced energy device used to deliver controlled energy to ligate and divide tissue, while minimizing thermal injury to surrounding structures. The Company has also developed the SurgiBot System, a single-port, robotically enhanced laparoscopic surgical platform. In December 2017, the Company entered into an agreement with Great Belief International Limited, or GBIL, to advance the SurgiBot System towards global commercialization. The agreement transferred ownership of the SurgiBot System assets to GBIL, while the Company retained the option to distribute or co-distribute the SurgiBot System outside of China. GBIL intends to manufacture the SurgiBot System in China, obtain Chinese regulatory clearance from the National Medical Products Administration ("NMPA"), and commercialize in the Chinese market. The agreement provides the Company with proceeds of at least $29.0 million, of which $15.0 million has been received to date. The remaining $14.0 million represents minimum royalties and will be paid beginning at the earlier of receipt of Chinese regulatory approval or March 2023. On September 18, 2015, the Company entered into a Membership Interest Purchase Agreement, (the “Purchase Agreement”) with Sofar S.p.A., (“Sofar”) as seller, Vulcanos S.r.l. (“Vulcanos”), as the acquired company, and TransEnterix International, Inc. (“TransEnterix International”), a direct, wholly owned subsidiary of the Company that was incorporated in September 2015, as buyer. The closing of the transactions occurred on September 21, 2015 (the “Closing Date”) pursuant to which the Company acquired all of the membership interests of Vulcanos from Sofar (now known as the “Senhance Acquisition”), and changed the name of Vulcanos to TransEnterix Italia S.r.l (“TransEnterix Italia”). The Senhance Acquisition included all of the assets, employees and contracts related to the Senhance System. See Note 3 for a description of the related transactions. On September 3, 2013, TransEnterix Surgical, Inc. a Delaware corporation (“TransEnterix Surgical”), and SafeStitch Medical, Inc., a Delaware corporation (“SafeStitch”) consummated a merger transaction whereby TransEnterix Surgical merged with a merger subsidiary of SafeStitch, with TransEnterix Surgical as the surviving entity in the merger (the “Merger”). As a result of the Merger, TransEnterix Surgical became a wholly owned subsidiary of SafeStitch. On December 6, 2013, SafeStitch changed its name to TransEnterix, Inc. and increased the authorized shares of common stock from 225,000,000 to 750,000,000, and authorized 25,000,000 shares of preferred stock, par value $0.01 per share. As used herein, the term “Company” refers to the combination of SafeStitch and TransEnterix Surgical after giving effect to the Merger, and includes TransEnterix International, Inc.; TransEnterix Italia S.r.l.; TransEnterix Europe S.à.R.L; TransEnterix Asia Pte. Ltd.; TransEnterix Taiwan Ltd.; TransEnterix Japan KK; TransEnterix Israel Ltd. and TransEnterix Netherlands B.V.

Summary of Significant Accounting Policies - Summary of Estimated Lives of Assets (Detail)	6 Months Ended
	Jun. 30, 2019
Computer equipment
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives	3 years
Furniture
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives	5 years
Minimum \| Machinery, manufacturing and demonstration equipment
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives	3 years
Minimum \| Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives	3 years
Maximum \| Machinery, manufacturing and demonstration equipment
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives	5 years
Maximum \| Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives	10 years

Summary of Significant Accounting Policies (Policies)

6 Months Ended

Jun. 30, 2019

Accounting Policies [Abstract]

Basis of Presentation

Going Concern

Use of Estimates

Cash and Cash Equivalents and Restricted Cash

The Company considers all highly liquid investments with original maturities of 90 days or less at the time of purchase to be cash equivalents.

Short-term Investments

Concentrations and Credit Risk

Accounts Receivable

Inventories

Identifiable Intangible Assets and Goodwill

In-Process Research and Development

The IPR&D from MST was acquired on October 31, 2018.

Property and Equipment

Property and equipment consists primarily of machinery, manufacturing equipment, demonstration equipment, computer equipment, furniture, and leasehold improvements, which are recorded at cost.

Depreciation is recorded using the straight-line method over the estimated useful lives of the assets as follows:



Machinery, manufacturing and demonstration equipment	3-5 years
Computer equipment	3 years
Furniture	5 years
Leasehold improvements	Lesser of lease term or 3 to 10 years

Impairment of Long-Lived Assets

Contingent Consideration

Warrant Liabilities

Translation of Foreign Currencies

Business Acquisitions

Risk and Uncertainties

Revenue Recognition

•


•	Service. Service revenue is recognized ratably over the term of the service period as the customers benefit from the service throughout the service period. Revenue related to services performed on a time-and-materials basis is recognized when performed.

The following table presents revenue disaggregated by type and geography:



	Three Months Ended				Six Months Ended
	2019		2018		2019		2018
	(in thousands) (unaudited)
U.S.
Systems	$	—	$	875	$	—	$	875
Instruments and accessories	25		409		25		409
Services	127		28		260		49
Total U.S. revenue	152		1,312		285		1,333
Outside of U.S. ("OUS")
Systems	2,737		3,782		4,024		7,236
Instruments and accessories	535		1,101		1,081		2,212
Services	215		194		430		375
Total OUS revenue	3,487		5,077		5,535		9,823
Total
Systems	2,737		4,657		4,024		8,111
Instruments and accessories	560		1,510		1,106		2,621
Services	342		222		690		424
Total revenue	$	3,639	$	6,389	$	5,820	$	11,156

The Company recognizes sales by geographic area based on the country in which the customer is based.

Cost of Revenue

Research and Development Costs

Stock-Based Compensation

Income Taxes

Comprehensive (Loss) Income

Comprehensive (loss) income 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

Impact of Recently Issued Accounting Standards

of the lease. The weighted average discount rate as of June 30, 2019 was 7.8% . There was no change to the Company’s consolidated statements of operations and comprehensive loss or cash flows.

The details of this adjustment are summarized below.



	Balance at December 31, 2018		Adjustments Due to ASC 842		Balance at January 1, 2019
	(unaudited) (In thousands)
Assets
Other long term assets	$	—	$	1,751	$	1,751
Liabilities and Stockholders' Equity
Accrued expenses	—		507		507
Other long term liabilities	$	—	$	1,244	$	1,244

Goodwill, In-Process Research and Development and Intellectual Property (Tables)

6 Months Ended

Jun. 30, 2019

Schedule of Goodwill and Intangible Assets [Line Items]

Carrying Value of Goodwill and Change in Balance

The carrying value of goodwill and the change in the balance for the six months ended June 30, 2019 is as follows:



	Goodwill
	(In thousands) (unaudited)
Balance at December 31, 2018	$80,131
Foreign currency translation impact	(227	)
Balance at June 30, 2019	$79,904

Carrying Value of Company's Intangible Assets and Change in Balance

The components of gross intellectual property, accumulated amortization, and net intellectual property as of June 30, 2019 and December 31, 2018 are as follows:



	June 30, 2019									December 31, 2018
	(In thousands) (unaudited)									(In thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign currency translation impact		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization			Foreign currency translation impact		Net Carrying Amount
Developed technology	$	66,413	$	(35,725	)	$	3,168	$	33,856	$	66,413	$	(30,550	)	$	3,495	$	39,358
Technology and patents purchased	400		(93		)	27		334		400		(72		)	30		358
Total intellectual property	$	66,813	$	(35,818	)	$	3,195	$	34,190	$	66,813	$	(30,622	)	$	3,525	$	39,716

In-Process Research and Development

Schedule of Goodwill and Intangible Assets [Line Items]

Carrying Value of Company's Intangible Assets and Change in Balance

The carrying value of the Company’s IPR&D assets and the change in the balance for the six months ended June 30, 2019 is as follows:



	In-Process Research and Development
	(In thousands) (unaudited)
Balance at December 31, 2018	$	10,747
Foreign currency translation impact	(80		)
Balance at June 30, 2019	$	10,667

Income Taxes	6 Months Ended
Income Taxes	Jun. 30, 2019
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes Income taxes have been accounted for using the asset and liability method in accordance with ASC 740 “Income Taxes”. The Company computes its interim provision for income taxes by applying the estimated annual effective tax rate method. The Company estimates an annual effective tax rate of 4.3% for the year ending December 31, 2019. This rate does not include the impact of any discrete items. The Company incurred losses for the six month period ended June 30, 2019 and is forecasting additional losses through the year, resulting in an estimated net loss for both financial statement and tax purposes for the year ending December 31, 2019. Due to the Company’s history of losses, there is not sufficient evidence to record a net deferred tax asset associated with the U.S., Luxembourg, Swiss, and Asian operations. Accordingly, a full valuation allowance has been recorded related to the net deferred tax assets in those jurisdictions. The Swiss jurisdiction has indefinite-lived intangibles that create deferred tax liabilities which cannot be offset against the deferred tax assets, resulting in a net deferred tax liability recorded in that jurisdiction. There is no net deferred tax asset recorded in relation to TransEnterix Italia and accordingly no valuation allowance has been recorded in that jurisdiction. The deferred tax benefit during the six months ended June 30, 2019 and 2018, was approximately $1.5 million and $1.8 million, respectively. The Israeli jurisdiction was profitable through June 30, 2019 and is projected to be profitable for the year ending December 31, 2019. Consequently, $0.03 million of current tax expense was recorded during the six months ended June 30, 2019 for this jurisdiction. The Company’s effective tax rate for each of the six month periods ended June 30, 2019 and 2018 was 3.4% and 4.8%, respectively. At June 30, 2019, the Company had no unrecognized tax benefits that would affect the Company’s effective tax rate. The Tax Legislation subjects a U.S. shareholder to tax on global intangible low-taxed income (“GILTI”) earned by certain foreign subsidiaries. The FASB Staff Q&A, Topic 740, No. 5, Accounting for Global Intangible Low-Taxed Income, states that an entity can make an accounting policy election to either recognize deferred taxes for temporary basis differences expected to reverse as GILTI in future years or to provide for the tax expense related to GILTI in the year the tax is incurred as a period expense only. Because the Company was evaluating the provision of GILTI as of December 31, 2017, no GILTI-related deferred amounts were recorded in 2017. The Company has elected to account for GILTI in the year the tax is incurred. The Company does not expect a GILTI inclusion for 2018 or 2019; no GILTI tax has been recorded for the six months ending June 30, 2019 or 2018.

Summary of Significant Accounting Policies (Tables)

6 Months Ended

Jun. 30, 2019

Accounting Policies [Abstract]

Summary of Estimated Lives of Assets

Depreciation is recorded using the straight-line method over the estimated useful lives of the assets as follows:



Machinery, manufacturing and demonstration equipment	3-5 years
Computer equipment	3 years
Furniture	5 years
Leasehold improvements	Lesser of lease term or 3 to 10 years

Summary of Revenue Disaggregated by Type and Geography

The following table presents revenue disaggregated by type and geography:



	Three Months Ended				Six Months Ended
	2019		2018		2019		2018
	(in thousands) (unaudited)
U.S.
Systems	$	—	$	875	$	—	$	875
Instruments and accessories	25		409		25		409
Services	127		28		260		49
Total U.S. revenue	152		1,312		285		1,333
Outside of U.S. ("OUS")
Systems	2,737		3,782		4,024		7,236
Instruments and accessories	535		1,101		1,081		2,212
Services	215		194		430		375
Total OUS revenue	3,487		5,077		5,535		9,823
Total
Systems	2,737		4,657		4,024		8,111
Instruments and accessories	560		1,510		1,106		2,621
Services	342		222		690		424
Total revenue	$	3,639	$	6,389	$	5,820	$	11,156

Summary of Details of Adjustment

The details of this adjustment are summarized below.



	Balance at December 31, 2018		Adjustments Due to ASC 842		Balance at January 1, 2019
	(unaudited) (In thousands)
Assets
Other long term assets	$	—	$	1,751	$	1,751
Liabilities and Stockholders' Equity
Accrued expenses	—		507		507
Other long term liabilities	$	—	$	1,244	$	1,244

Summary of Minimum Lease Payments

The following table presents the minimum lease payments as of June 30, 2019 (in thousands):



July 1, 2019 to December 31, 2019	662
January 1, 2020 to December 31, 2020	1,317
January 1, 2021 to December 31, 2021	669
January 1, 2022 to December 31, 2022	404
January 1, 2023 to December 31, 2023	194
January 1, 2024 to December 31, 2024	33
Thereafter	—
Total minimum lease payments	3,279
Less: Amount of lease payments representing interest	(352	)
Present value of future minimum lease payments	2,927

Goodwill, In-Process Research and Development and Intellectual Property

6 Months Ended

Jun. 30, 2019

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill, In-Process Research and Development and Intellectual Property

Goodwill

Goodwill of $93.8 million was recorded in connection with the Merger, as described in Note 1, goodwill of $38.3 million was recorded in connection with the Senhance Acquisition, as described in Note 3, and goodwill of $9.6 million was recorded in connection with the MST Acquisition, as described in Note 3. The carrying value of goodwill and the change in the balance for the six months ended June 30, 2019 is as follows:



	Goodwill
	(In thousands) (unaudited)
Balance at December 31, 2018	$80,131
Foreign currency translation impact	(227	)
Balance at June 30, 2019	$79,904

Accumulated impairment of goodwill as of June 30, 2019 and December 31, 2018 was $61.8 million.

No impairment was recorded during the six months ended June 30, 2019 or 2018.

In-Process Research and Development

As described in Note 3, on October 31, 2018, the Company acquired the MST assets, technology and business from MST and recorded $10.6 million of IPR&D. The estimated fair value of the IPR&D was determined using a probability-weighted income approach, which discounts expected future cash flows to present value. The projected cash flows were based on certain key assumptions, including estimates of future revenue and expenses, taking into account the stage of development of the technology at the acquisition date and the time and resources needed to complete development. The Company used a discount rate of 15% and cash flows that have been probability adjusted to reflect the risks of product integration, which the Company believes are appropriate and representative of market participant assumptions.

The carrying value of the Company’s IPR&D assets and the change in the balance for the six months ended June 30, 2019 is as follows:



	In-Process Research and Development
	(In thousands) (unaudited)
Balance at December 31, 2018	$	10,747
Foreign currency translation impact	(80		)
Balance at June 30, 2019	$	10,667

Intellectual Property

As described in Note 3, on September 21, 2015, the Company acquired all of the developed technology related to the Senhance System and recorded $48.5 million of intellectual property. The estimated fair value of the intellectual property was determined using a probability-weighted income approach, which discounts expected future cash flows to present value. The projected cash flows were based on certain key assumptions, including estimates of future revenue and expenses, taking into account the stage of development of the technology at the acquisition date and the time and resources needed to complete development. The Company used a discount rate of 45% and cash flows that have been probability adjusted to reflect the risks of product commercialization, which the Company believes are appropriate and representative of market participant assumptions.

As described in Note 3, on September 21, 2015, the Company acquired all of the assets related to the Senhance System and recorded $17.1 million of IPR&D. The estimated fair value of the IPR&D was determined using a probability-weighted income approach, which discounts expected future cash flows to present value. The projected cash flows were based on certain key assumptions, including estimates of future revenue and expenses, taking into account the stage of development of the technology at the acquisition date and the time and resources needed to complete development. The Company used a discount rate of 45% and cash flows that have been probability adjusted to reflect the risks of product commercialization, which the Company believes are appropriate and representative of market participant assumptions. On October 13, 2017, upon regulatory approval and the ability to commercialize the products associated with the IPR&D assets, the assets were deemed definite-lived, reclassified to intellectual property and are now being amortized based on their estimated useful lives.

The components of gross intellectual property, accumulated amortization, and net intellectual property as of June 30, 2019 and December 31, 2018 are as follows:



	June 30, 2019									December 31, 2018
	(In thousands) (unaudited)									(In thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign currency translation impact		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization			Foreign currency translation impact		Net Carrying Amount
Developed technology	$	66,413	$	(35,725	)	$	3,168	$	33,856	$	66,413	$	(30,550	)	$	3,495	$	39,358
Technology and patents purchased	400		(93		)	27		334		400		(72		)	30		358
Total intellectual property	$	66,813	$	(35,818	)	$	3,195	$	34,190	$	66,813	$	(30,622	)	$	3,525	$	39,716

The weighted average remaining useful life of the developed technology and technology and patents purchased was 3.3 years and 7.8 years, respectively as of June 30, 2019. The weighted average remaining useful life of the developed technology and technology and patents purchased was 3.8 years and 8.3 years, respectively as of December 31, 2018.

Basic and Diluted Net Loss per Share	6 Months Ended
Basic and Diluted Net Loss per Share	Jun. 30, 2019
Earnings Per Share [Abstract]
Basic and Diluted Net Loss per Share	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 dilutive potential common shares that were outstanding during the period. Diluted potential common shares consist of incremental shares issuable upon exercise of stock options, warrants and restricted stock units. For the three and six month periods ended June 30, 2019, the effect of outstanding warrants is reflected in diluted net loss per common share by applying the treasury stock method resulting in 1.1 million and 1.4 million incremental shares that were included in the weighted average number of commons shares used in the diluted net loss per common share calculation for the three months and six months ended June 30, 2019, respectively. Additionally, the gain on the fair value of warrant liabilities of $2.5 million and $2.4 million for the three and six month periods ended June 30, 2019, respectively, increased the net loss attributable to common stockholders in calculating diluted net loss per common share. No adjustments have been made to the weighted average outstanding common shares figures for the three and six months periods ended June 30, 2018. As of June 30, 2019, there were 25,884,445 outstanding options, 1,400,352 outstanding warrants, and 6,191,419 unvested restricted stock units that were excluded from the calculation of diluted net loss per common share as the effect of including these instruments would have been anti-dilutive.

Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	750,000,000	750,000,000
Common stock, shares issued	217,625,492	216,345,984
Common stock, shares outstanding	217,625,492	216,345,984

Goodwill, In-Process Research and Development and Intellectual Property - Carrying Value of Company's IPR&D Assets and Change in Balance (Detail) - In-Process Research and Development $ in Thousands	6 Months Ended
	Jun. 30, 2019 USD ($)
Finite-lived Intangible Assets [Roll Forward]
Beginning balance	$ 10,747
Foreign currency translation impact	(80)
Ending balance	$ 10,667

Notes Payable	6 Months Ended
Notes Payable	Jun. 30, 2019
Debt Disclosure [Abstract]
Notes Payable	Notes Payable On May 23, 2018, the Company and its domestic subsidiaries, as co-borrowers, entered into a Loan and Security Agreement (the “Hercules Loan Agreement”) with several banks and other financial institutions or entities from time to time party to the Loan Agreement (collectively, the “Lender”) and Hercules Capital, Inc., as administrative agent and collateral agent (the “Agent”). Under the Hercules Loan Agreement, the Lender agreed to make certain term loans to the Company in the aggregate principal amount of up to $40.0 million, with funding of the first $20.0 million tranche occurring on May 23, 2018 (the “Initial Funding Date”). On October 23, 2018, the Lender funded the second tranche of $10.0 million under the Hercules Loan Agreement. The Company is entitled to make interest-only payments until December 1, 2020, and at the end of the interest-only period, the Company will be required to repay the term loans over an eighteen-month period based on an eighteen-month amortization schedule, with a final maturity date of June 1, 2022. The term loans will be required to be repaid if the term loans are accelerated following an event of default. Effective April 30, 2019, the Hercules Loan Agreement was amended (the “Hercules Amendment”) to eliminate the availability of the Tranche III Loan facility, add a new Tranche IV Loan facility of up to $20.0 million, revise certain financial covenants and make other changes. The availability of advances under the Tranche IV Loan is not milestone-based, rather the Company could request advances in minimum $5.0 million increments at any time during the period from July 1, 2019 through December 31, 2020, subject to the funding discretion of the Lender. The monthly trailing six month net revenue financial covenant was amended to be tested quarterly and to change the projected net revenue percentage to be met for the six months ending on the last day of each fiscal quarter. If such quarterly financial covenant is not achieved as of the last day of any fiscal quarter, as tested on the thirtieth day after quarter end, the Company must comply with the waiver conditions in the Hercules Amendment from such test date until the next quarterly test date. As of June 30, 2019, the Company did not meet the financial covenant related to actual net revenue as compared to projected net revenue, but did meet the applicable 2019 fiscal year waiver condition of maintenance of unrestricted cash, which includes short-term investments, equal to the term loan balances and a market capitalization of at least $250 million. Therefore, the Company was in compliance with its debt covenants or related waiver conditions, as set forth in the Hercules Amendment, as of June 30, 2019. The Hercules Amendment was executed by the parties on May 7, 2019. The Amendment was treated as a debt modification for accounting purposes. The term loans bear interest at a rate equal to the greater of (i) 10.05% per annum (the “Fixed Rate”) and (ii) the Fixed Rate plus the prime rate (as reported in The Wall Street Journal) minus 5.00%. On the Initial Funding Date, the Company was obligated to pay a facility fee of $0.4 million, recorded as a debt discount. The Company also incurred other debt issuance costs totaling $1.1 million in conjunction with its entry into the Hercules Loan Agreement. In addition, the Company is permitted to prepay the term loans in full at any time, with a prepayment fee of 3.0% of the outstanding principal amount of the loan in the first year after the Initial Funding Date, 2.0% if the prepayment occurs in the second year after the Initial Funding Date and 1.0% thereafter. Upon prepayment of the term loans in full or repayment of the terms loans at the maturity date or upon acceleration, the Company is required to pay a final fee of 6.95% of the aggregate principal amount of term loans funded. The final payment fee is accreted to interest expense over the life of the term loan and included within notes payable on the consolidated balance sheet. The Company’s obligations under the Hercules Loan Agreement are guaranteed by all current and future material foreign subsidiaries of the Company and are secured by a security interest in all of the assets of the Company and their current and future domestic subsidiaries and all of the assets of their current and future material foreign subsidiaries, including a security interest in the intellectual property. The Hercules Loan Agreement contains customary representations and covenants that, subject to exceptions, restrict the Company’s and its subsidiaries’ ability to do the following, among other things: declare dividends or redeem or repurchase equity interests; incur additional indebtedness and liens; make loans and investments; engage in mergers, acquisitions, and asset sales; transact with affiliates; undergo a change in control; add or change business locations; and engage in businesses that are not related to its existing business. Under the terms of the Hercules Loan Agreement, the Company is required to maintain cash and/or investment property in accounts which perfect the Agent’s first priority security interest in such accounts in an amount equal to the lesser of (i) (x) 120% of the then-outstanding principal balance of the term loans, including accrued interest and any other fees payable under the agreement to the extent accrued and payable plus (y) an amount equal to the then-outstanding accounts payable of the Company on a consolidated basis that are more than 90 days past due and (ii) 80% of the aggregate cash of the Company and its consolidated subsidiaries. As of June 30, 2019, the Company was in compliance with its debt covenants. The Agent is granted the option to invest up to $2.0 million in any future equity offering broadly marketed by the Company to investors on the same terms as the offering to other investors. In connection with its entrance into the Hercules Loan Agreement, the Company repaid its existing loan and security agreement (the “Innovatus Loan Agreement”) with Innovatus Life Sciences Lending Fund I, LP (“Innovatus”). The Company recognized a loss of $1.4 million on the extinguishment of notes payable which is included in interest expense on the consolidated statement of operations and comprehensive loss for the year ended December 31, 2018. The Company paid $0.7 million in final payment obligations and $0.3 million in prepayment fees under the Innovatus Loan Agreement upon repayment. Under the Innovatus Loan Agreement, entered into on May 10, 2017, Innovatus agreed to make certain term loans in the aggregate principal amount of up to $17.0 million. Funding of the first $14.0 million tranche occurred on May 10, 2017. The Innovatus Loan Agreement allowed for interest-only payments for up to twenty-four months at a fixed rate equal to 11% per annum, of which 2.5% could be paid in-kind and added to the outstanding principal amount of the term loans until the earlier of (i) the first anniversary following the funding date and (ii) the Company’s failure to achieve an Interest-Only Milestone. At the end of the interest-only period, the Company would be required to repay the term loans over a two-year period, based on a twenty-four (24) month amortization schedule, with a final maturity date of May 10, 2021. In connection with the Innovatus funding, the Company paid a facility fee of $0.2 million on the date of funding of the first tranche and incurred additional debt issuance costs of approximately $1.2 million, recorded as a debt discount. In addition, the Company issued warrants to Innovatus to purchase shares of the Company’s common stock that will expire five (5) years from such issue date. The warrants issued in connection with funding of the first tranche entitle Innovatus to purchase up to 1,244,746 shares of the Company’s common stock at an exercise price of $1.00 per share. The Company estimated the fair value of the warrants to be $0.3 million. The value of the warrants was classified as equity and recorded as a discount to the loan. The debt discount was amortized as interest expense using the effective interest method over the life of the loan. As of December 31, 2018, the unamortized debt discount was $0.

Income Taxes - Additional Information (Detail) - USD ($)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018	Dec. 31, 2017
Income Tax Contingency [Line Items]
Estimates annual effective tax rate			4.30%
Deferred tax benefit			$ 1,479,000	$ 1,799,000
Current tax expense	$ (869,000)	$ (883,000)	$ (1,479,000)	$ (1,773,000)
Effective tax rate			3.40%	4.80%
Unrecognized tax benefits that would affect effective tax rate	0		$ 0
GILTI deferred amounts						$ 0
GILTI income tax			0		$ 0
Foreign Tax Authority \| TransEnterix Italia
Income Tax Contingency [Line Items]
Net deferred tax asset	0		0
Valuation allowance	$ 0		0
Foreign Tax Authority \| Israel Tax Authority
Income Tax Contingency [Line Items]
Current tax expense			$ 30,000.00

Fair Value (Tables)

6 Months Ended

Jun. 30, 2019

Fair Value Measurements Disclosure [Line Items]

Summary of Assets Measured at Fair Value on Recurring Basis

The following are the major categories of assets and liabilities measured at fair value on a recurring basis as of June 30, 2019 and December 31, 2018, using quoted prices in active markets for identical assets (Level 1); significant other observable inputs (Level 2); and significant unobservable inputs (Level 3):



	June 30, 2019
	(In thousands) (unaudited)
Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents	$	23,302	$	—	$	—	$	23,302
Restricted cash	712		—		—		712
Total Assets measured at fair value	$	24,014	$	—	$	—	$	24,014
Liabilities measured at fair value
Contingent consideration	—		—		12,595		12,595
Warrant liabilities	—		—		2,214		2,214
Total liabilities measured at fair value	$	—	$	—	$	14,809	$	14,809



Description	December 31, 2018
	(In thousands)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents	$	21,061	$	—	$	—	$	21,061
Restricted cash	590		—		—		590
Total Assets measured at fair value	$	21,651	$	—	$	—	$	21,651
Liabilities measured at fair value
Contingent consideration	$	—	$	—	$	10,637	$	10,637
Warrant liabilities	—		—		4,636		4,636
Total liabilities measured at fair value	—		—		15,273		15,273

Change in Fair Value for All Assets and Liabilities Using Unobservable Level 3 Inputs As Determined By Level 3 Inputs

The following table summarizes the change in fair value, as determined by Level 3 inputs, for all assets and liabilities using unobservable Level 3 inputs for the six months ended June 30, 2019:



	Fair Value Measurement at Reporting Date (Level 3)
	(In thousands) (unaudited)
	Common stock warrants			Contingent consideration
Balance at December 31, 2018	$	4,636		$	10,637
Change in fair value	(2,422		)	1,958
Balance at June 30, 2019	$	2,214		$	12,595
Current portion	—			74
Long-term portion	2,214			12,521
Balance at June 30, 2019	$	2,214		$	12,595

Level 3

Fair Value Measurements Disclosure [Line Items]

Quantitative Information about Inputs and Valuation Methodologies Used for Fair Value Measurements Classification

The following table presents quantitative information about the inputs and valuation methodologies used for the Company’s fair value measurements classified in Level 3 with the exception of the warrant liability, which is explained above as of June 30, 2019 and December 31, 2018:



	Valuation Methodology	Significant Unobservable Input	Weighted Average (range, if applicable)
Contingent consideration	Probability weighted income approach	Milestone dates	2019 to 2022
		Discount rate	10% to 12%

Series B Warrant

Fair Value Measurements Disclosure [Line Items]

Quantitative Information about Inputs and Valuation Methodologies Used for Fair Value Measurements Classification

The following table presents the inputs and valuation methodologies used for the Company’s fair value of the Series B Warrants:



Series B	June 30, 2019	December 31, 2018	April 28, 2017 (date of issuance)
Fair value	$2.2 milllion	$4.6 milllion	$6.2 milllion
Valuation methodology	Monte Carlo	Monte Carlo	Black-Scholes Merton
Term	2.8 years	3.3 years	5.0 years
Risk free rate	1.71%	2.47%	1.81%
Dividends	—	—	—
Volatility	82.34%	87.60%	73.14%
Share price	$1.36	$2.26	$0.65
Probability of additional financing	100% in 2019	100% in 2019	Not Applicable

Acquisitions

6 Months Ended

Jun. 30, 2019

Business Combinations [Abstract]

Acquisitions

MST Medical Surgery Technologies Ltd. Acquisition

On September 23, 2018, the Company entered into an Asset Purchase Agreement (the “MST Purchase Agreement”) with MST Medical Surgery Technologies Ltd., an Israeli private company (the “Seller”), and two of the Company’s wholly owned subsidiaries, as purchasers of the assets of the Seller, including the intellectual property assets (collectively, the “Buyers”). The closing of the transactions occurred on October 31, 2018, pursuant to which the Company acquired the Seller’s assets consisting of intellectual property and tangible assets related to surgical analytics with its core image analytics technology designed to empower and automate the surgical environment, with a focus on medical robotics and computer-assisted surgery. The core technology acquired under the MST Purchase Agreement is a software-based image analytics information platform powered by advanced visualization, scene recognition, artificial intelligence, machine learning and data analytics.

Under the terms of the MST Purchase Agreement, at the closing the Buyers purchased substantially all of the assets of the Seller. The acquisition price consisted of two tranches. At or prior to the closing of the transaction the Buyers paid $5.8 million in cash and the Company issued 3.15 million shares of the Company’s common stock. A second tranche of $6.6 million in additional consideration will be payable in cash, stock or cash and stock, at the discretion of the Company, within one year after the closing date.

The MST Purchase Agreement contains customary representations and warranties of the parties and the parties have customary indemnification obligations, which are subject to certain limitations described further in the MST Purchase Agreement.

In connection with the closing under the MST Purchase Agreement (the “MST Acquisition”), the Company and the Seller entered into a Lock-Up Agreement, dated October 31, 2018, pursuant to which the Seller agreed, subject to certain exceptions, not to sell, transfer or otherwise convey any of the shares of Company common stock (the “Securities Consideration”) for six months following the Closing Date. As of the date of this report, 50% of the Securities Consideration is free from the lock-up restrictions. For the remaining 50% of the Securities Consideration, the Lock-Up Agreement provides that an additional 25% of the Securities

Consideration will be released from the lock-up restrictions on the twelve-month anniversary of the Closing Date and all of the Securities Consideration will be released from the lock-up restrictions on the eighteen-month anniversary of the closing date, or earlier upon certain other conditions. The Lock-Up Agreement further provides that the Seller may not sell, transfer or convey the additional consideration, if such additional consideration is paid in whole or in part through the issuance of shares of the Company’s common stock, until after the six-month anniversary of the issuance of the Company’s common stock as additional consideration, or earlier upon certain other conditions.

In connection with the MST Acquisition closing, the Company also entered into a Registration Rights Agreement, dated as of October 31, 2018, with the Seller, pursuant to which the Company agreed to register the Securities Consideration such that such Securities Consideration is eligible for resale following the end of the lock-up periods described above.

The MST Purchase Agreement was accounted for as a business combination utilizing the methodology prescribed in ASC 805. The purchase price for the acquisition was allocated to the assets acquired and liabilities assumed based on their estimated fair values.

The following table summarizes the acquisition date fair value of the consideration (in thousands).



Stock consideration	$	8,300
Cash consideration	5,800
Present value of deferred consideration	5,900
Other consideration	314
Total consideration	$	20,314

The value of the stock consideration was determined based on the fair value of the stock on the closing date, adjusted for a lack of marketability discount related to the Lock-Up Agreement. The value of the deferred consideration was determined based on the present value of the future payment using a market interest rate.

The following table summarizes the estimated fair values of the assets acquired and liabilities assumed on October 31, 2018, the date of acquisition (in thousands):



Property and equipment	$	43
In-process research and development	10,633
Goodwill	9,638
Net assets acquired	$	20,314

The Company allocated $10.6 million of the purchase price to identifiable intangible assets of in-process research and development that met the separability and contractual legal criterion of ASC 805. IPR&D is principally the estimated fair value of the MST technology which had not reached commercial technological feasibility nor had alternative future use at the time of the acquisition and therefore the Company considered IPR&D, with assigned values to be allocated to the IPR&D assets acquired.

Goodwill is calculated as the difference between the acquisition-date fair value of the consideration transferred and the fair values of the assets acquired and liabilities assumed. The goodwill resulting from this acquisition arises largely from synergies expected from combining the intellectual property acquired from MST with the Company’s existing intellectual property as well as acquired employees. The goodwill is deductible for income tax purposes.

Senhance Surgical Robotic System

On September 21, 2015, the Company completed the strategic acquisition, through its wholly owned subsidiary TransEnterix International, from Sofar, 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, the consideration consisted of the issuance of (i) 15,543,413 shares of the Company’s common stock (the “Securities Consideration”) and (ii) approximately $25.0 million U.S. Dollars and €27.5 million Euro in cash consideration (the “Cash Consideration”). On December 30, 2016, the Company and Sofar entered into an Amendment to the Purchase Agreement (the “Amendment”) to restructure the terms of the second tranche of the Cash Consideration (the “Second Tranche”). The initial Securities Consideration was issued in full at the closing of the Senhance Acquisition; under the Amendment, the second tranche of the Cash Consideration was restructured, and an additional issuance of 3,722,685 shares of the Company’s common stock with an aggregate fair market value of €5.0 million occurred in January 2017. Following the Amendment, the total Cash Consideration was $25.0 million U.S. Dollars and approximately €22.5 million Euro, of which all but €15.1 million Euro has been paid as of June 30, 2019. The majority of the remaining Cash Consideration to be paid is the third tranche of the Cash Consideration (the

“Third Tranche”) of €15.0 million which shall be payable upon achievement of trailing revenues from sales or services contracts of the Senhance System of at least €25.0 million over a calendar quarter. The Third Tranche payments will be accelerated in the event that (i) the Company or TransEnterix International is acquired, (ii) the Company significantly reduces or suspends selling efforts of the Senhance System, or (iii) the Company acquires a business that offers alternative products that are directly competitive with the Senhance System.

Fair Value

6 Months Ended

Jun. 30, 2019

Fair Value Disclosures [Abstract]

Fair Value

The Company held certain assets and liabilities that are required to be measured at fair value on a recurring basis. These assets and liabilities include cash and cash equivalents, restricted cash, contingent consideration and warrant liabilities. ASC 820-10 (“Fair Value Measurement Disclosure”) requires the valuation using a three-tiered approach, which requires that fair value measurements be classified and disclosed in one of three tiers. These tiers are: Level 1, defined as quoted prices in active markets for identical assets or liabilities; Level 2, defined as valuations based on observable inputs other than those included in Level 1, such as quoted prices for similar assets and liabilities in active markets, or other inputs that are observable or can be corroborated by observable input data; and Level 3, defined as valuations based on unobservable inputs reflecting the Company’s own assumptions, consistent with reasonably available assumptions made by other market participants. The Company did not have any transfers of assets and liabilities between Level 1, Level 2, and Level 3 of the fair value hierarchy during the six months ended June 30, 2019 and the year ended December 31, 2018.

For assets and liabilities recorded at fair value, it is the Company’s policy to maximize the use of observable inputs and minimize the use of unobservable inputs when developing fair value measurements, in accordance with the fair value hierarchy. Fair value measurements for assets and liabilities where there exists limited or no observable market data and therefore, are based primarily upon estimates, are often calculated based on the economic and competitive environment, the characteristics of the asset or liability and other factors. Therefore, the results cannot be determined with precision and may not be realized in an actual sale or immediate settlement of the asset or liability. Additionally, there may be inherent weaknesses in any calculation technique, and changes in the underlying assumptions used, including discount rates and estimates of future cash flows, could significantly affect the results of current or future values. The Company utilizes fair value measurements to record fair value adjustments to certain assets and liabilities and to determine fair value disclosures.

As prescribed by U.S. GAAP, the Company groups assets and liabilities at fair value in three levels, based on the markets in which the assets and liabilities are traded and the reliability of the assumptions used to determine fair value. An adjustment to the pricing method used within either Level 1 or Level 2 inputs could generate a fair value measurement that effectively falls in a lower level in the hierarchy.

The determination of where an asset or liability falls in the hierarchy requires significant judgment. The Company evaluates its hierarchy disclosures and based on various factors, it is possible that an asset or liability may be classified differently from period to period. However, the Company expects changes in classifications between levels will be rare.

The carrying values of accounts receivable, short-term investments, interest receivable, accounts payable, and certain accrued expenses at June 30, 2019 and December 31, 2018, approximate their fair values due to the short-term nature of these items. The Company’s notes payable balance also approximates fair value as of June 30, 2019 and December 31, 2018, as the interest rates on the notes payable approximate the rates available to the Company as of these dates.



	June 30, 2019
	(In thousands) (unaudited)
Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents	$	23,302	$	—	$	—	$	23,302
Restricted cash	712		—		—		712
Total Assets measured at fair value	$	24,014	$	—	$	—	$	24,014
Liabilities measured at fair value
Contingent consideration	—		—		12,595		12,595
Warrant liabilities	—		—		2,214		2,214
Total liabilities measured at fair value	$	—	$	—	$	14,809	$	14,809



Description	December 31, 2018
	(In thousands)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents	$	21,061	$	—	$	—	$	21,061
Restricted cash	590		—		—		590
Total Assets measured at fair value	$	21,651	$	—	$	—	$	21,651
Liabilities measured at fair value
Contingent consideration	$	—	$	—	$	10,637	$	10,637
Warrant liabilities	—		—		4,636		4,636
Total liabilities measured at fair value	—		—		15,273		15,273

The Company’s financial liabilities consisted of contingent consideration potentially payable to Sofar related to the Senhance Acquisition in September 2015 (Note 3). This liability is reported as Level 3 as estimated fair value of the contingent consideration related to the acquisition requires significant management judgment or estimation and is calculated using the income approach, using various revenue and cost assumptions and applying a probability to each outcome. The change in fair value of the contingent consideration of $2.0 million for the six months ended June 30, 2019 was primarily due to the passage of time and a decrease in the discount rate used. The change in fair value of the contingent consideration of $1.4 million for the six months ended June 30, 2018 was primarily due to the passage of time on the fair value measurement and the impact of foreign currency exchange rates. Adjustments associated with the change in fair value of contingent consideration are included in the Company’s consolidated statements of operations and comprehensive loss.

On April 28, 2017, the Company sold 24.9 million units (the “Units”), each consisting of one share of the Company’s Common Stock, a Series A warrant to purchase one share of Common Stock with an exercise price of $1.00 per share (the “Series A Warrants”), and a Series B warrant to purchase 0.75 shares of Common Stock with an exercise price of $1.00 per Unit (the “Series B Warrants,” together with the Series A Warrants, the “Warrants”), at an offering price of $1.00 per Unit. Each Series A Warrant was exercisable at any time beginning on the date of issuance, and from time to time thereafter, through and including the first anniversary of the issuance date, unless terminated earlier as provided in the Series A Warrant. Receipt of 510(k) clearance for the Senhance System on October 13, 2017 triggered the acceleration of the expiration date of the Series A Warrants to October 31, 2017. Each Series B Warrant may be exercised at any time beginning on the date of issuance and from time to time thereafter through and including the fifth anniversary of the issuance date.

The fair value of the Series A Warrants of $2.5 million at the date of issuance was estimated using the Black-Scholes Merton model which used the following inputs: term of 1 year, risk free rate of 1.07%, no dividends, volatility of 73.14%, and share price of $0.65 per share based on the trading price of the Company’s Common Stock. All Series A Warrants were exercised as of October 31, 2017.

The change in fair value of all outstanding Series B Warrants for the six months ended June 30, 2019 was a decrease of $2.4 million compared to an increase of $15.7 million for the six months ended June 30, 2018, and is included in the Company’s consolidated statements of operations and comprehensive loss. The following table presents the inputs and valuation methodologies used for the Company’s fair value of the Series B Warrants:



Series B	June 30, 2019	December 31, 2018	April 28, 2017 (date of issuance)
Fair value	$2.2 milllion	$4.6 milllion	$6.2 milllion
Valuation methodology	Monte Carlo	Monte Carlo	Black-Scholes Merton
Term	2.8 years	3.3 years	5.0 years
Risk free rate	1.71%	2.47%	1.81%
Dividends	—	—	—
Volatility	82.34%	87.60%	73.14%
Share price	$1.36	$2.26	$0.65
Probability of additional financing	100% in 2019	100% in 2019	Not Applicable



	Valuation Methodology	Significant Unobservable Input	Weighted Average (range, if applicable)
Contingent consideration	Probability weighted income approach	Milestone dates	2019 to 2022
		Discount rate	10% to 12%

The following table summarizes the change in fair value, as determined by Level 3 inputs, for all assets and liabilities using unobservable Level 3 inputs for the six months ended June 30, 2019:



	Fair Value Measurement at Reporting Date (Level 3)
	(In thousands) (unaudited)
	Common stock warrants			Contingent consideration
Balance at December 31, 2018	$	4,636		$	10,637
Change in fair value	(2,422		)	1,958
Balance at June 30, 2019	$	2,214		$	12,595
Current portion	—			74
Long-term portion	2,214			12,521
Balance at June 30, 2019	$	2,214		$	12,595

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Goodwill, In-Process Research and Development and Intellectual Property - Summary of Gross Intellectual Property, Accumulated Amortization, and Net Intellectual Property (Detail) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2019	Dec. 31, 2018
Developed Technology
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount	$ 66,413	$ 66,413
Accumulated amortization	(35,725)	(30,550)
Foreign currency translation impact	3,168	3,495
Net carrying amount	33,856	39,358
Technology and Patents Purchased
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount	400	400
Accumulated amortization	(93)	(72)
Foreign currency translation impact	27	30
Net carrying amount	334	358
Intellectual Property
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount	66,813	66,813
Accumulated amortization	(35,818)	(30,622)
Foreign currency translation impact	3,195	3,525
Net carrying amount	$ 34,190	$ 39,716

Cash, Cash Equivalents, and Restricted Cash - Additional Information (Detail) - USD ($) $ in Millions	Jun. 30, 2019	Dec. 31, 2018
Held In Cash Collateral Accounts
Restricted Cash and Cash Equivalents Items [Line Items]
Restricted cash	$ 0.7	$ 0.6

Accounts Receivable, Net (Tables)

6 Months Ended

Jun. 30, 2019

Receivables [Abstract]

Summary of Accounts Receivable

The following table presents the components of accounts receivable:



	June 30, 2019			December 31, 2018
	(In thousands)
	(unaudited)
Gross accounts receivable	$	5,749		$	8,640
Allowance for uncollectible accounts	(80		)	(80		)
Total accounts receivable, net	$	5,669		$	8,560

Goodwill, In-Process Research and Development and Intellectual Property - Carrying Value of Goodwill and Change in Balance (Detail) $ in Thousands	6 Months Ended
	Jun. 30, 2019 USD ($)
Goodwill and Intangible Assets Disclosure [Roll Forward]
Beginning balance	$ 80,131
Foreign currency translation impact	(227)
Ending balance	$ 79,904

Acquisitions (Tables) - Medical Surgery Technologies Ltd.

6 Months Ended

Jun. 30, 2019

Business Acquisition [Line Items]

Summary of Fair Value Consideration

The following table summarizes the acquisition date fair value of the consideration (in thousands).



Stock consideration	$	8,300
Cash consideration	5,800
Present value of deferred consideration	5,900
Other consideration	314
Total consideration	$	20,314

Schedule of Estimated Fair Values of Assets Acquired and Liabilities Assumed

The following table summarizes the estimated fair values of the assets acquired and liabilities assumed on October 31, 2018, the date of acquisition (in thousands):



Property and equipment	$	43
In-process research and development	10,633
Goodwill	9,638
Net assets acquired	$	20,314

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Operating Activities
Net loss			$ (42,696)	$ (35,130)
Adjustments to reconcile net loss to net cash and cash equivalents used in operating activities:
Loss (gain) from sale of SurgiBot assets, net	$ 0	$ 37	97	(11,959)
Depreciation			1,126	1,277
Amortization of intangible assets	2,585	2,743	5,196	5,570
Amortization of debt discount and debt issuance costs			622	495
Amortization of short-term investment discount			(300)	0
Interest expense on deferred consideration - MST acquisition			387	0
Stock-based compensation			6,336	4,204
Deferred tax benefit			(1,479)	(1,799)
Write down of inventory			761	0
Change in fair value of warrant liabilities	(2,528)	17,507	(2,422)	15,678
Change in fair value of contingent consideration	960	812	1,958	1,439
Loss on extinguishment of debt			0	1,400
Changes in operating assets and liabilities:
Accounts receivable			2,808	(762)
Interest receivable			(4)	(24)
Inventories			(10,301)	(1,560)
Other current and long term assets			(3,689)	1,905
Accounts payable			2,499	404
Accrued expenses			(1,454)	(359)
Deferred revenue			(862)	31
Other long term liabilities			1,879	0
Net cash and cash equivalents used in operating activities			(39,538)	(19,190)
Investing Activities
Purchase of short-term investments			(12,883)	0
Proceeds from maturities of short-term investments			55,000	0
Proceeds related to sale of SurgiBot assets, net			0	4,496
Purchase of property and equipment			(189)	(358)
Proceeds from sale of property and equipment			0	32
Net cash and cash equivalents provided by investing activities			41,928	4,170
Financing Activities
Payment of note payable			0	(15,305)
Proceeds from issuance of debt and warrants, net of issuance costs			(30)	18,870
Payment of contingent consideration			0	(395)
Proceeds from issuance of common stock and warrants, net of issuance costs			0	2
Taxes paid related to net share settlement of vesting of restricted stock units			(499)	0
Proceeds from issuance of common stock related to sale of SurgiBot assets			0	3,000
Proceeds from exercise of stock options and warrants			534	9,813
Net cash and cash equivalents provided by financing activities			5	15,985
Effect of exchange rate changes on cash and cash equivalents			(32)	(78)
Net increase in cash, cash equivalents and restricted cash			2,363	887
Cash, cash equivalents and restricted cash, beginning of period			21,651	97,606	$ 97,606
Cash, cash equivalents and restricted cash, end of period	$ 24,014	$ 98,493	24,014	98,493	$ 21,651
Supplemental Disclosure for Cash Flow Information
Interest paid			1,528	599
Supplemental Schedule of Noncash Investing and Financing Activities
Transfer of inventories to property and equipment			415	1,055
Reclass of warrant liability to common stock and additional paid-in capital			$ 0	$ 7,060

Summary of Significant Accounting Policies - Summary of Details of Adjustment (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Jan. 01, 2019	Dec. 31, 2018
Assets
Other long term assets	$ 2,818		$ 203
Liabilities and Stockholders’ Equity
Accrued expenses	8,182		9,619
Other long term liabilities	$ 1,894		$ 0
ASC 842
Assets
Other long term assets		$ 1,751
Liabilities and Stockholders’ Equity
Accrued expenses		507
Other long term liabilities		1,244
ASC 842 \| Restatement Adjustment
Assets
Other long term assets		1,751
Liabilities and Stockholders’ Equity
Accrued expenses		507
Other long term liabilities		$ 1,244

Property and Equipment (Tables)

6 Months Ended

Jun. 30, 2019

Property, Plant and Equipment [Abstract]

Summary of Property and Equipment

Property and equipment consisted of the following:



	June 30, 2019			December 31, 2018
	(In thousands)
	(unaudited)
Machinery, manufacturing and demonstration equipment	$	12,565		$	12,320
Computer equipment	2,297			2,260
Furniture	638			639
Leasehold improvements	2,287			2,280
Total property and equipment	17,787			17,499
Accumulated depreciation and amortization	(12,005		)	(11,162)
Property and equipment, net	$	5,782		$	6,337

Acquisitions - Additional Information (Detail) $ in Thousands					1 Months Ended	6 Months Ended		12 Months Ended
	Oct. 31, 2018 USD ($) shares	Dec. 30, 2016 shares	Sep. 21, 2015 USD ($) shares	Sep. 21, 2015 EUR (€) shares	Jan. 31, 2017 EUR (€)	Jun. 30, 2019 USD ($)	Jun. 30, 2019 EUR (€)	Dec. 31, 2018 USD ($)	Jun. 30, 2019 EUR (€)
Business Acquisition [Line Items]
Cash consideration payable						$ 12,595		$ 10,637
Medical Surgery Technologies Ltd.
Business Acquisition [Line Items]
Cash consideration	$ 5,800
Additional consideration payable in cash, stock or cash and stock								10,600
Medical Surgery Technologies Ltd. \| Amount Unrestricted
Business Acquisition [Line Items]
Percentage of securities consideration						50.00%	50.00%
Medical Surgery Technologies Ltd. \| Ending on Twelve Month Anniversary \| Maximum
Business Acquisition [Line Items]
Percentage of securities consideration	25.00%
Medical Surgery Technologies Ltd. \| Ending on Eighteen Month Anniversary \| Maximum
Business Acquisition [Line Items]
Percentage of securities consideration	25.00%
Medical Surgery Technologies Ltd. \| First Tranche
Business Acquisition [Line Items]
Cash consideration	$ 5,800
Common shares issued (in shares) \| shares	3,150,000
Medical Surgery Technologies Ltd. \| Second Tranche
Business Acquisition [Line Items]
Additional consideration payable in cash, stock or cash and stock	$ 6,600
Senhance Surgical Robotic System Acquisition
Business Acquisition [Line Items]
Common shares issued (in shares) \| shares			15,543,413	15,543,413
Additional consideration payable in cash, stock or cash and stock						$ 12,600		$ 10,600
Senhance Surgical Robotic System Acquisition \| U.S. Dollars
Business Acquisition [Line Items]
Cash consideration			$ 25,000
Senhance Surgical Robotic System Acquisition \| Euro
Business Acquisition [Line Items]
Cash consideration \| €				€ 27,500,000
Senhance Surgical Robotic System Acquisition \| Second Tranche
Business Acquisition [Line Items]
Cash consideration \| €							€ 15,100,000
Common shares issued (in shares) \| shares		3,722,685
Aggregate fair market value \| €					€ 5,000,000.0
Senhance Surgical Robotic System Acquisition \| Second Tranche \| U.S. Dollars
Business Acquisition [Line Items]
Cash consideration payable						$ 25,000
Senhance Surgical Robotic System Acquisition \| Second Tranche \| Euro
Business Acquisition [Line Items]
Cash consideration payable \| €									€ 22,500,000
Senhance Surgical Robotic System Acquisition \| Third Tranche
Business Acquisition [Line Items]
Cash consideration payable \| €									15,000,000.0
Senhance Surgical Robotic System Acquisition \| Third Tranche \| Minimum
Business Acquisition [Line Items]
Target revenue to be achieved \| €									€ 25,000,000.0

At-The-Market Offering - Additional Information (Detail) - Stifel, Nicolaus & Company, Incorporated - USD ($) $ in Millions		6 Months Ended
	Dec. 28, 2018	Jun. 30, 2019
Stockholders Equity Common Stock [Line Items]
Percentage of commission paid	3.00%
Total shares of common stock sold (in shares)		0
Maximum
Stockholders Equity Common Stock [Line Items]
Sale of common stock in an at-the-market offering	$ 75.0

Organization and Capitalization - Additional Information (Detail) - USD ($)	1 Months Ended
	Dec. 31, 2017	Jun. 30, 2019	Dec. 31, 2018	Dec. 06, 2013
Organization And Capitalization [Line Items]
Common stock, shares authorized		750,000,000	750,000,000
Preferred stock, shares authorized				25,000,000
Preferred stock, par value (in dollars per share)				$ 0.01
Minimum
Organization And Capitalization [Line Items]
Common stock, shares authorized				225,000,000
Maximum
Organization And Capitalization [Line Items]
Common stock, shares authorized				750,000,000
China National Scientific and Instruments and Materials Company
Organization And Capitalization [Line Items]
Proceeds from distribution agreement	$ 15,000,000.0
Distribution minimum royalties payment	14,000,000.0
China National Scientific and Instruments and Materials Company \| Minimum
Organization And Capitalization [Line Items]
Expected proceeds from distribution agreement	$ 29,000,000.0

Accounts Receivable, Net - Summary of Accounts Receivable (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Receivables [Abstract]
Gross accounts receivable	$ 5,749	$ 8,640
Allowance for uncollectible accounts	(80)	(80)
Total accounts receivable, net	$ 5,669	$ 8,560

Accrued Expenses - Schedule of Accrued Expenses (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Accrued Liabilities, Current [Abstract]
Compensation and benefits	$ 2,731	$ 6,225
Consulting and other vendors	2,188	895
Other	610	539
Lease liability	1,033	0
Royalties	539	498
Legal and professional fees	311	432
Deferred rent	0	391
Taxes and other assessments	519	383
Interest	251	256
Total	$ 8,182	$ 9,619

Cash, Cash Equivalents, and Restricted Cash	6 Months Ended
Cash, Cash Equivalents, and Restricted Cash	Jun. 30, 2019
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents [Abstract]
Cash, Cash Equivalents, and Restricted Cash	Cash, Cash Equivalents, and Restricted Cash Restricted cash at June 30, 2019 and December 31, 2018 includes $0.7 million and $0.6 million respectively, in cash accounts held as collateral primarily under the terms of an office operating lease, credit card agreement and automobile leases.

Summary of Significant Accounting Policies - Additional Information (Detail) € in Millions	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2019 USD ($)	Jun. 30, 2018 USD ($)	Jun. 30, 2019 USD ($) Segment	Jun. 30, 2018 USD ($)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Jun. 30, 2019 EUR (€)	Jan. 01, 2019
Accounting Policies [Line Items]
Accumulated deficit	$ 552,095,000		$ 552,095,000		$ 509,406,000
Working capital	46,800,000		46,800,000
Short-term investments	9,973,000		9,973,000		51,790,000
Cash, EU insured amount \| €							€ 0.1
Impairment charges			$ 0		0
Number of business segments \| Segment			1
Period of service sale arrangement			5 years
Period of service sale arrangement at stated service price			4 years
Product warranty			1 year
Revenue, remaining performance obligation	3,800,000		$ 3,800,000
Contract assets included in accounts receivable	200,000	$ 100,000	200,000	$ 100,000
Revenue recognized, included in deferred revenue	1,300,000		700,000	200,000
Write down of inventory			$ 761,000	0
Statutory income tax rate			21.00%
Decrease in deferred tax assets due to newly enacted tax rate						$ 36,100,000
Decrease in valuation allowance due to newly enacted tax rate						$ 36,100,000
Assets	$ 203,378,000		$ 203,378,000		239,307,000
Weighted average discount rate	7.80%		7.80%				7.80%
Right-of-use asset	$ 2,600,000		$ 2,600,000
Operating lease, liability	2,927,000		2,927,000
Lease liability current	1,033,000		1,033,000		$ 0
Lease liability noncurrent	$ 1,900,000		$ 1,900,000
Weighted average remaining lease term for operating leases	3 years		3 years				3 years
Cash paid for operating leases			$ 700,000
Operating Expenses
Accounting Policies [Line Items]
Operating lease cost	$ 400,000		$ 700,000
U.S.
Accounting Policies [Line Items]
Percentage of total consolidated assets	42.00%		42.00%		54.00%		42.00%
Outside of U.S.
Accounting Policies [Line Items]
Percentage of total consolidated assets, excluding goodwill	43.00%		43.00%		34.00%		43.00%
Senhance Surgical Robotic System Acquisition \| Europe
Accounting Policies [Line Items]
Assets	$ 118,400,000		$ 118,400,000		$ 111,000,000.0
Stock Options
Accounting Policies [Line Items]
Share based compensation, expense recognized			$ 6,300,000	$ 4,200,000
Patents
Accounting Policies [Line Items]
Amortization period			10 years
Minimum
Accounting Policies [Line Items]
Amortization period			5 years
Incremental borrowing rate								6.60%
Minimum \| Developed Technology
Accounting Policies [Line Items]
Amortization period			5 years
Maximum
Accounting Policies [Line Items]
Amortization period			10 years
Incremental borrowing rate								8.50%
Maximum \| Developed Technology
Accounting Policies [Line Items]
Amortization period			7 years
Customer Concentration Risk \| Accounts Receivable \| Five Customer
Accounting Policies [Line Items]
Concentration risk percentage			93.00%		89.00%
Customer Concentration Risk \| Sales \| Two Customer
Accounting Policies [Line Items]
Concentration risk percentage			76.00%
Customer Concentration Risk \| Sales \| Three Customer
Accounting Policies [Line Items]
Concentration risk percentage		96.00%
Customer Concentration Risk \| Sales \| Five Customer
Accounting Policies [Line Items]
Concentration risk percentage	91.00%			94.00%
Geographic Concentration Risk \| Sales \| U.S.
Accounting Policies [Line Items]
Concentration risk percentage			5.00%	12.00%
Geographic Concentration Risk \| Sales \| Outside of U.S.
Accounting Policies [Line Items]
Concentration risk percentage			95.00%	88.00%
U.S. Government Securities
Accounting Policies [Line Items]
Short-term investments	$ 10,000,000.0		$ 10,000,000.0		$ 51,800,000
Short-term investments, other-than-temporary impairment			0		0
Held In Cash Collateral Accounts
Accounting Policies [Line Items]
Restricted cash	$ 700,000		$ 700,000		$ 600,000

Warrants - Summary of Change in Warrant (Detail) - $ / shares	6 Months Ended	12 Months Ended
	Jun. 30, 2019	Dec. 31, 2018
Class of Warrant or Right [Line Items]
Weighted Average Remaining Contractual Life, Exercised	8 years 2 months 12 days
Warrants Not Settleable in Cash
Class of Warrant or Right [Line Items]
Number of Warrants, Outstanding, Beginning balance	4,329,437
Number of Warrants, Exercised	(200,000)
Number of Warrants, Outstanding, Ending balance	4,129,437	4,329,437
Weighted Average Exercise Price, Outstanding (in dollars per share), Beginning balance	$ 1.03
Weighted Average Exercise Price, Exercised (in dollars per share)	1.00
Weighted Average Exercise Price, Outstanding (in dollars per share), Ending balance	$ 1.03	$ 1.03
Weighted Average Remaining Contractual Life, Outstanding	3 years	3 years 8 months 12 days
Weighted Average Fair Value, Outstanding, Beginning balance (in dollars per share)	$ 0.26
Weighted Average Fair Value, Outstanding, Ending balance (in dollars per share)	$ 0.22	$ 0.26

Inventories (Tables)

6 Months Ended

Jun. 30, 2019

Inventory Disclosure [Abstract]

Schedule of Inventory

The components of inventories are as follows:



	June 30, 2019		December 31, 2018
	(In thousands)
	(unaudited)
Finished goods	$	9,586	$	5,439
Raw materials	10,505		5,502
Total inventories	$	20,091	$	10,941

Accounts Receivable, Net

6 Months Ended

Jun. 30, 2019

Receivables [Abstract]

Accounts Receivable, Net

The following table presents the components of accounts receivable:



	June 30, 2019			December 31, 2018
	(In thousands)
	(unaudited)
Gross accounts receivable	$	5,749		$	8,640
Allowance for uncollectible accounts	(80		)	(80		)
Total accounts receivable, net	$	5,669		$	8,560

- Definition

The entire disclosure for claims held for amounts due a entity, excluding financing receivables. Examples include, but are not limited to, trade accounts receivables, notes receivables, loans receivables. Includes disclosure for allowance for credit losses.

+ References + Details

Acquisitions - Summary of Fair Value Consideration (Detail) - Medical Surgery Technologies Ltd. $ in Thousands	Oct. 31, 2018 USD ($)
Business Acquisition [Line Items]
Stock consideration	$ 8,300
Cash consideration	5,800
Present value of deferred consideration	5,900
Other consideration	314
Total consideration	$ 20,314