0001437749-22-010891 | 10-Q | XBRL Viewer

Organization, Consolidation, Basis of Presentation, Business Description and Accounting Policies [Text Block]

1.	Description of the Business

Asensus Surgical, Inc. (formerly known as TransEnterix, Inc.) (the "Company") is a medical device company that is digitizing the interface between the surgeon and the patient to pioneer a new era of Performance-Guided Surgery™ by unlocking clinical intelligence for surgeons to enable consistently superior outcomes and a new standard of surgery. The Company is focused on the market development for and commercialization of the Senhance® Surgical System, which digitizes laparoscopic minimally invasive surgery, or MIS. The Senhance System is the first and only digital, multi-port laparoscopic platform designed to maintain laparoscopic MIS standards while providing digital benefits such as haptic feedback, robotic precision, comfortable ergonomics, advanced instrumentation including 3mm microlaparoscopic instruments, 5mm articulating instruments, eye-sensing camera control and fully-reusable standard instruments to help maintain per-procedure costs similar to traditional laparoscopy.

Note 2 - Summary of Significant Accounting Policies

3 Months Ended

Mar. 31, 2022

Significant Accounting Policies [Text Block]

2.	Summary of Significant Accounting Policies

Basis of Presentation

The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and include the accounts of the Company and its direct and indirect wholly owned subsidiaries. All inter-company accounts and transactions have been eliminated in consolidation. The results reported in these unaudited interim condensed consolidated financial statements should not 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 consolidated financial statements and the notes thereto included in the Fiscal 2021 Form 10-K. Certain information and footnote disclosures normally included in the annual consolidated financial statements prepared in accordance with U.S. GAAP have been condensed or omitted in the accompanying interim condensed consolidated financial statements. In the opinion of the Company’s management, the accompanying unaudited condensed consolidated financial statements 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

Principles of Consolidation

The accompanying condensed consolidated financial statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., Asensus International, Inc., Asensus Surgical Italia S.r.l., Asensus Surgical Europe S.à.r.l., Asensus Surgical Taiwan Ltd., Asensus Surgical Japan K.K., Asensus Surgical Israel Ltd., Asensus Surgical Netherlands B.V., and Asensus Surgical Canada, Inc. All inter-company accounts and transactions have been eliminated in consolidation.

Risk and Uncertainties

The Company is subject to risks similar to other similarly sized companies in the medical device industry. These risks include, without limitation: negative impacts on the Company's operations caused by the COVID-19 pandemic; the historical lack of profitability; the Company’s ability to raise additional capital; the success of its market development efforts, 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 company; competition in the market for robotic surgical devices; and its ability to identify and pursue development of additional products.

Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Significant items subject to such estimates and assumptions include impairment considerations for long- term intangible assets, fair value estimates related to contingent consideration, stock compensation expense, revenue recognition, accounts receivable reserves, short-term and long-term investments, excess and obsolete inventory reserves, inventory classification between current and non-current, measurement of lease liabilities and corresponding right-of-use (“ROU”) assets, and deferred tax asset valuation allowances.

Significant Accounting Policies

There have been no new or material changes to the significant accounting policies discussed in the Company’s audited financial statements and the notes thereto included in the Annual Report on Form 10-K for the fiscal year ended December 31, 2021.

Reclassifications

Certain amounts reported previously have been reclassified to conform to current year presentation, with no effect on stockholders’ equity or net loss as previously reported. These reclassifications relate to revenue and cost of revenue for leases which historically was included in product and service revenue and corresponding cost of revenue on the condensed consolidated statements of operations and comprehensive loss for the three months ended March 31, 2021.

Impact of Recently Issued Accounting Standards

In June 2016, the Financial Accounting Standards Board (“FASB”), issued ASU 2016-13, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, which is designed to provide financial statement users with more information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. The Company adopted ASU 2016-13 as of January 1, 2022, on a modified retrospective basis. The cumulative-effect adjustment related to the adoption was not material.

In August 2020, the FASB issued ASU 2020-06, Debt – Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40) guidance on the accounting for convertible debt instruments and contracts in an entity’s own equity. The guidance simplifies the accounting for convertible instruments by reducing the various accounting models that can require the instrument to be separated into a debt component and equity component or derivative component. The Company adopted ASU 2020-06 as of January 1, 2022. The adoption did not have a material impact to the consolidated financial statements.

The Company has evaluated all other issued and ASUs not yet adopted and believes the adoption of these standards will not have a material impact on its condensed consolidated statements of operations and comprehensive loss, balance sheets, or statements of cash flows.

Note 3 - Revenue Recognition

3 Months Ended

Mar. 31, 2022

Revenue from Contract with Customer [Text Block]

3.	Revenue Recognition

The following table presents revenue disaggregated by type and geography:

	Three Months Ended March 31,
	2022		2021
	(in thousands)
U.S.
Systems	$	-	$	3
Instruments and accessories		64		62
Services		74		98
Leases		113		90
Total U.S. revenue		251		253

Outside of U.S. ("OUS")
Systems		-		921
Instruments and accessories		283		377
Services		234		281
Leases		298		251
Total OUS revenue		815		1,830

Total
Systems		-		924
Instruments and accessories		347		439
Services		308		379
Leases		411		341
Total revenue	$	1,066	$	2,083

Remaining Performance Obligations

Transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which the revenue has not yet been recognized. A significant portion of this amount relates to service obligations performed under the Company's system sales contracts that will be invoiced and recognized as revenue in future periods. Transaction price allocated to remaining performance obligations as of March 31, 2022 was $2.6 million, which is expected to be recognized over one to four years.

Contract Assets and Liabilities

The Company invoices its customers based on the billing schedules in its sales arrangements. Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative selling price of the related performance obligations and the contractual billing terms in the arrangements. Deferred revenue for the periods presented was primarily related to service obligations, for which the service fees are billed up-front, generally annually. The associated deferred revenue is generally recognized ratably over the service period. The Company did not have any significant impairment losses on its contract assets for the periods presented. Revenue recognized for the three months ended March 31, 2022 and 2021 that was included in the deferred revenue balance at the beginning of each reporting period was $0.2 million and $0.2 million, respectively

The following information summarizes the Company’s contract assets and liabilities:

	As of
	March 31, 2022		December 31, 2021
	(in thousands)
Contract Assets	$	68	$	91
Deferred Revenue	$	533	$	543

Senhance System Leasing

The Company enters into operating lease arrangements with certain qualified customers. Revenue related to arrangements including lease elements are allocated to lease and non-lease elements based on their relative standalone selling prices. Lease elements generally include a Senhance System, while non-lease elements generally include instruments, accessories, and services. For some lease arrangements, the customers are provided with the option to purchase the leased System at some point during and/or at the end of the lease term. In some arrangements lease payments are based on the usage of the System. For the three months ended March 31, 2022, and 2021, variable lease revenue related to usage-based arrangements was not material.

Trade Accounts Receivable

The allowance for doubtful accounts is based on the Company’s assessment of collectability of customer accounts. The Company regularly reviews the allowance by considering factors such as historical experience, credit quality, the age of the accounts receivable balances, and current economic conditions that may affect a customer’s ability to pay. The allowance for doubtful accounts was $1.8 million and $1.7 million as of March 31, 2022, and December 31, 2021, respectively. For the three months ended March 31, 2022, and 2021, bad debt expense was not material.

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

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Note 4 - Fair Value

3 Months Ended

Mar. 31, 2022

Fair Value Disclosures [Text Block]

4.	Fair Value

The following are categories of assets and liabilities measured at fair value on a recurring basis using quoted prices in active markets for identical assets (Level 1); significant other observable inputs (Level 2); and significant unobservable inputs (Level 3):

	March 31, 2022
	(in thousands)

Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents⁽¹⁾	$	24,828	$	-	$	-	$	24,828
Restricted cash		1,176		-		-		1,176
Short-term investments		-		78,913		-		78,913
Long-term investments		-		14,727		-		14,727
Total assets measured at fair value	$	26,004	$	93,640	$	-	$	119,644
Liabilities measured at fair value
Contingent consideration	$	-	$	-	$	2,217	$	2,217
Total liabilities measured at fair value	$	-	$	-	$	2,217	$	2,217

⁽¹⁾Includes investments that are readily convertible to cash with original maturities of 90 days or less.

	December 31, 2021
	(in thousands)

Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents⁽¹⁾	$	18,129	$	-	$	-	$	18,129
Restricted cash		1,154		-		-		1,154
Short-term investments		-		80,262		-		80,262
Long-term investments		-		37,435		-		37,435
Total assets measured at fair value	$	19,283	$	117,697	$	-	$	136,980
Liabilities measured at fair value
Contingent consideration	$	-	$	-	$	2,371	$	2,371
Total liabilities measured at fair value	$	-	$	-	$	2,371	$	2,371

⁽¹⁾Includes investments that are readily convertible to cash with original maturities of 90 days or less.

The carrying values of accounts receivable, other current assets, accounts payable, and accrued expenses as of March 21, 2022, and December 31, 2021, approximate their fair values due to the short-term nature of these items.

The Company’s financial liabilities consisted of contingent consideration payable to Sofar, S.p.A., the seller, related to the Company’s 2015 acquisition of the Senhance Surgical System (the “Senhance Acquisition”). Adjustments associated with the change in fair value of contingent consideration are included in the Company’s condensed consolidated statements of operations and comprehensive loss.

The following table presents quantitative information about the inputs and valuation methodologies used for the Company’s fair value measurements for contingent consideration utilizing a Monte-Carlo simulation as of March 31, 2022 and December 31, 2021:

	Valuation Methodology	Significant Unobservable Input	March 31, 2022		December 31, 2021

Contingent consideration	Probability weighted income approach	Milestone dates		2031		2031
		Discount rate		9.5%		9.5%
		Revenue volatility		40.0%		39.0%
		EUR-to-USD exchange rate		1.11		1.14

The following table summarizes the change in fair value, as determined by Level 3 inputs for the contingent consideration for the three months ended March 31, 2022 and 2021:

	Fair Value Measurement at Reporting Date (Level 3)
	(in thousands)
	Series B Warrants			Contingent consideration
Balance at December 31, 2020	$	255		$	3,936
Exercise of warrants		(2,236	)		-
Change in fair value		1,981			257
Balance at March 31, 2021	$	-		$	4,193

Balance at December 31, 2021		-			2,371
Change in fair value		-			(154	)
Balance at March 31, 2022	$	-		$	2,217

Current portion	$	-		$	-
Long-term portion		-			2,217
Balance at March 31, 2022	$	-		$	2,217

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

Note 5 - Investments, Available-for-sale

3 Months Ended

Mar. 31, 2022

Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]

5.	Investments, available-for-sale

The aggregate fair values of investment securities along with unrealized gains and losses determined on an individual investment security basis and included in other comprehensive loss are as follows:

	March 31, 2022
	(in thousands)

	Amortized Cost		Unrealized Gain		Unrealized Loss			Fair Value		Short-term investments		Long-term investments
Commercial Paper	$	44,124	$	-	$	(191	)	$	43,933	$	43,933	$	-
Corporate Bonds		50,314		-		(607	)		49,707		34,980		14,727
Total Investments	$	94,438	$	-	$	(798	)	$	93,640	$	78,913	$	14,727

	December 31, 2021
	(in thousands)

	Amortized Cost		Unrealized Gain		Unrealized Loss			Fair Value		Short-term investments		Long-term investments
Commercial Paper	$	50,705	$	-	$	(46	)	$	50,659	$	50,660	$	-
Corporate Bonds		67,239		1		(202	)		67,038		29,602		37,435
Total Investments	$	117,944	$	1	$	(248	)	$	117,697	$	80,262	$	37,435

The following table summarizes the contractual maturities of the Company’s available-for-sale investments:

	March 31, 2022
	(in thousands)
	Amortized Cost		Fair Value
Mature in less than one year	$	79,453	$	78,913
Mature in one to two years		14,985		14,727
Total	$	94,438	$	93,640

Actual maturities may differ from contractual maturities because certain borrowers have the right to call or prepay certain obligations. There were no sales of investments or gross realized gains or losses for the three months ended March 31, 2022, and 2021, respectively.

Note 6 - Inventories

3 Months Ended

Mar. 31, 2022

Inventory Disclosure [Text Block]

6.	Inventories

The components of inventories are as follows:

	March 31, 2022
	(in thousands)

	Gross Carrying Amount		Reserve Balance			Net Carrying Amount
Finished goods	$	11,318	$	(3,061	)	$	8,257
Raw materials		10,811		(2,440	)		8,371
Total inventories	$	22,129	$	(5,501	)	$	16,628

Current Portion	$	10,468	$	(1,327	)	$	9,141
Long-term portion		11,661		(4,174	)		7,487
Total inventories	$	22,129	$	(5,501	)	$	16,628

	December 31, 2021
	(in thousands)

	Gross Carrying Amount		Reserve Balance			Net Carrying Amount
Finished goods	$	10,566	$	(2,987	)	$	7,579
Raw materials		10,824		(2,695	)		8,129
Total inventories	$	21,390	$	(5,682	)	$	15,708

Current Portion	$	9,931	$	(1,297	)	$	8,634
Long-term portion		11,459		(4,385	)		7,074
Total inventories	$	21,390	$	(5,682	)	$	15,708

Note 7 - Intellectual Property

3 Months Ended

Mar. 31, 2022

Intangible Assets Disclosure [Text Block]

7.	Intellectual Property

The components of gross intellectual property, accumulated amortization, and net intellectual property are as follows:

	March 31, 2022
	(in thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign Currency Translation Impact			Net Carrying Amount
Developed technology	$	68,838	$	(60,086	)	$	(1,954	)	$	6,798
Technology and patents purchased		400		(205	)		16			211
Total intellectual property	$	69,238	$	(60,291	)	$	(1,938	)	$	7,009

	December 31, 2021
	(in thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign Currency Translation Impact			Net Carrying Amount
Developed technology	$	68,838	$	(58,912	)	$	(262	)	$	9,664
Technology and patents purchased		400		(199	)		27			228
Total intellectual property	$	69,238	$	(59,111	)	$	(235	)	$	9,892

The weighted average remaining useful life of the developed technology and technology and patents purchased was 1.6 years and 5.1 years, respectively, as of March 31, 2022.

Note 8 - Leases

3 Months Ended

Mar. 31, 2022

Lessee, Operating Leases [Text Block]

8.	Leases

Lessee Information

The Company determines if an arrangement is a lease or service contract at inception. Where an arrangement is a lease, the Company determines if it is an operating lease or a finance lease. Subsequently, if the arrangement is modified, the Company reevaluates the classification. The Company has entered into operating leases for corporate office buildings, vehicles, and machinery and equipment. Some of the lease agreements have renewal options, tenant improvement allowances, rent escalation clauses, and assignment and subletting clauses. While the operating leases range from one year to ten years, some include options to extend the lease generally between one year and six years, and some include options to terminate the leases within one year.

Components of operating lease expense are primarily recorded in general and administrative on the condensed consolidated statements of operations were as follows:

	Three Months Ended March 31,
	2022		2021
	(in thousands)
Long-term Operating	$	398	$	438
Short-term Operating		-		-
Total Operating lease expense	$	398	$	438

Supplemental balance sheet information related to operating leases was as follows:

	March 31, 2022			December 31, 2021
Weighted-average remaining lease term (in years)		7.7			7.8
Weighted-average discount rate		7.8%			7.8%
Incremental borrowing rate	6.1%	-	8.5%	6.1%	-	8.5%

Maturities of operating lease obligations as of March 31, 2022 were as follows (in thousands):

Fiscal Year
2022	$	694
2023		1,008
2024		915
2025		909
2026		845
Thereafter		2,990
Total minimum lease payments	$	7,361
Less: Amount of lease payments representing interest		(1,892	)
Present value of future minimum lease payments	$	5,469

Note 9 - Income Taxes

3 Months Ended

Mar. 31, 2022

Income Tax Disclosure [Text Block]

9.	Income Taxes

Income taxes have been accounted for using the asset and liability method in accordance with ASC 740, 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 (0.3)% for the year ending December 31, 2022. This rate does not include the impact of any discrete items. The Company’s effective tax rate for the three months ended March 31, 2022 and 2021 was (0.4)% and 0.2%, respectively.

The Company incurred losses for the three month period ended March 31, 2022 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, 2022. 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, Italian, Taiwanese, and Canadian operations. Accordingly, a full valuation allowance has been recorded related to the net deferred tax assets in those jurisdictions.

Income tax (expense) benefit on the condensed consolidated statement of operations and comprehensive loss during the three months ended March 31, 2022 and 2021, was approximately ($0.08) million and $0.04 million, respectively. At March 31, 2022, the Company had no unrecognized tax benefits that would affect the Company’s effective tax rate.

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. The Company does not expect a GILTI inclusion for 2022; no GILTI tax has been recorded for the three months ended March 31, 2022 or 2021.

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

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-Name Accounting Standards Codification
-Topic 740
-SubTopic 30
-Section 50
-Paragraph 2
-Subparagraph (a)
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (SX 210.4-08(h)(2))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Note 10 - Stock-based Compensation

3 Months Ended

Mar. 31, 2022

Share-Based Payment Arrangement [Text Block]

10.

Stock-Based Compensation

Stock Options

The following table summarizes the Company’s stock option activity, including grants to non-employees, for the three months ended March 31, 2022:

	Number of Shares			Weighted- Average Exercise Price		Weighted-Average Remaining Contractual Term (Years)
Balance at December 31, 2021		4,640,660		$	6.64		5.66
Granted		2,173,832			0.82
Forfeited		(4,155	)		1.71
Cancelled		(13,816	)		38.80
Exercised		(30,001	)		0.41
Balance at March 31, 2022		6,766,520		$	4.74		5.91

The following table summarizes information about stock options outstanding at March 31, 2022:

Number of

Shares

Weighted-

Average Exercise

Price

Weighted-Average

Remaining

Contractual Term

(Years)

Aggregate

Intrinsic Value

(Millions)

Exercisable at March 31, 2022

2,392,065

10.06

5.41

0.2

Vested or expected to vest at March 31, 2022

6,421,165

4.91

5.88

0.4

Restricted Stock Units

The following is a summary of the RSU activity, including performance restricted stock units, for the three months ended March 31, 2022:

	Number of Restricted Stock Units Outstanding			Weighted- Average Grant Date Fair Value
Unvested December 31, 2021		3,839,030		$	2.36
Granted		5,133,307			0.80
Vested		(1,603,449	)		2.53
Forfeited		(69,777	)		1.49
Unvested March 31, 2022		7,299,111		$	1.24

Performance Restricted Stock Units

In 2022 and 2021, the Company granted performance-based restricted stock units with vesting terms based on our attainment of certain operational targets by October 1, 2023 and October 1, 2022, respectively. The number of shares earnable under the 2022 and 2021 awards were based on achieving designated corporate goals.

Share-based Compensation Expense

The following table summarizes non-cash share-based compensation expense by award type for the three months ended March 31, 2022, and 2021:

	Three Months Ended March 31,
	2022		2021
	(in thousands)
Stock options	$	978	$	1,119
Restricted stock units		883		629
Performance restricted stock units		384		38
	$	2,245	$	1,786

As of March 31, 2022, the Company had future employee stock-based compensation expense of approximately $4.4 million related to unvested stock options, which is expected to be recognized over an estimated weighted-average period of 1.9 years. As of March 31, 2022, the unrecognized stock-based compensation expense related to unvested RSUs was approximately $6.7 million, which is expected to be recognized over a weighted average period of approximately 1.9 years.

The fair value of options granted were estimated using the Black-Scholes-Merton option pricing model based on the assumptions in the table below:

	Three Months Ended March 31,
	2022			2021
Expected dividend yield		0%			0%
Expected volatility	131%	-	133%	118%	-	136%
Risk-free interest rate	1.25%	-	1.94%	0.33%	-	0.58%
Expected life (in years)	4.3	-	4.5	3.8	-	4.5%

Note 11 - Financing Transactions

3 Months Ended

Mar. 31, 2022

Stockholders' Equity Note Disclosure [Text Block]

11.

Equity Offerings

Equity financing transactions for the three months ended March 31, 2021, include:

January 2021 Public Offering. On January 29, 2021, the Company completed an underwritten public offering of 26,545,832 shares of its common stock, including the underwriter’s full exercise of an over-allotment option on February 1, 2021, at the public offering price of $3.00 per share, generating net proceeds of approximately $73.4 million.

January 2021 Registered Direct Purchase Agreement. On January 12, 2021, the Company sold in a registered direct offering 25,000,000 shares of common stock at a purchase price per share of $1.25 for aggregate net proceeds of $28.6 million.

Sales during the three months ended March 31, 2021, under the 2020 ATM Offering are as follows (in thousands except for share and per share amounts):

	Three Months Ended March 31, 2021

Total shares of common stock sold		19,120,037
Average price per share	$	1.47
Gross proceeds	$	28,100
Commission earned by Sales Agents	$	843
Net proceeds	$	27,257

2021 Exercise of Warrants. During the three months ended March 31, 2021, certain holders of our Series B, C and D warrants to purchase shares of our common stock exercised such warrants for aggregate proceeds to the Company of $30.5 million.

On March 18, 2022, the Company entered a Controlled Equity OfferingSales Agreement (the “2022 Sales Agreement”), with Cantor Fitzgerald & Co., and Oppenheimer & Co. Inc. The Company commenced an at-the-market offering (the “2022 ATM Offering”) pursuant to which the Company could sell from time to time, at its option, up to an aggregate of $100.0 million shares of the Company’s common stock. No sales of common stock were made under the 2022 ATM Offering during the three months ended March 31, 2022.

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
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-Paragraph 6
-Subparagraph (a)
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Note 12 - Basic and Diluted Net Loss Per Share

3 Months Ended

Mar. 31, 2022

Earnings Per Share [Text Block]

12.

Basic and Diluted Net Loss per Share

Basic net loss per common share is computed by dividing net loss attributable to common stockholders by the weighted average number of common shares outstanding during the period. Diluted net loss per common share is computed giving effect to all potential dilutive common shares that were outstanding during the period when the effect is dilutive. Potential dilutive common shares consist of incremental shares issuable upon exercise of stock options, restricted stock units, and warrants. No adjustments have been made to the weighted average outstanding common shares figures for the three months ended March 31, 2022 or 2021 as the assumed exercise of outstanding options, warrants and restricted stock units would be anti-dilutive.

Potential common shares not included in calculating diluted net loss per share are as follows:

	March 31,
	2022		2021
Stock options		6,766,520		4,731,249
Stock warrants		1,120,300		1,323,995
Nonvested restricted stock units		7,299,111		2,688,342
Total		15,185,931		8,743,586

Note 13 - Commitments and Contingencies

3 Months Ended

Mar. 31, 2022

Commitments and Contingencies Disclosure [Text Block]

13.

Commitments and Contingencies

License and Supply Agreements

As part of the Company’s acquisition of the Senhance System in 2015, the Company assumed certain license and supply agreements. Additionally, the Company has purchase orders with various suppliers for certain tooling, supplies, contract engineering and research services. Commitments related to these agreements and purchase orders are as follows (in thousands):

Fiscal Year
2022	$	6,296
2023		1,304
2024		223
2025		1,201
2026		-
Thereafter		-
Total commitments	$	9,024

Note 14 - Segments and Geographic Areas

3 Months Ended

Mar. 31, 2022

Segment Reporting Disclosure [Text Block]

14.

Segments and Geographic Areas

The Company operates in one business segment—the research, development and sale of medical device robotics to improve minimally invasive surgery. The Company’s chief operating decision maker (determined to be the Chief Executive Officer), does not 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.

The following table presents consolidated assets and long lived assets by geographic area, which includes property and equipment, intellectual property, and operating lease assets:

	March 31, 2022
	Long-Lived Assets			Total Assets
U.S.		30	%		78	%

EMEA
Switzerland		35	%		16	%
Italy		29	%		4	%
Other		6	%		1	%
Total EMEA		70	%		21	%

Asia		0	%		1	%
Total		100	%		100	%

	December 31, 2021
	Long-Lived Assets			Total Assets
U.S.		26	%		77	%

EMEA
Switzerland		34	%		16	%
Italy		36	%		5	%
Other		4	%		1	%
Total EMEA		74	%		22	%

Asia		0	%		1	%
Total		100	%		100	%

The Company recognizes sales by geographic area based on the country in which the customer is based. For the three months ended March 31, 2022 and 2021, 24% and 12%, respectively, of net revenue were generated in the United States; while 48% and 21%, respectively, were generated in Europe; and 28% and 67% were generated in Asia.

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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Significant Accounting Policies (Policies)	3 Months Ended
Significant Accounting Policies (Policies)	Mar. 31, 2022
Accounting Policies [Abstract]
Basis of Accounting, Policy [Policy Text Block]	Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and include the accounts of the Company and its direct and indirect wholly owned subsidiaries. All inter-company accounts and transactions have been eliminated in consolidation. The results reported in these unaudited interim condensed consolidated financial statements should not 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 consolidated financial statements and the notes thereto included in the Fiscal 2021 Form 10-K. Certain information and footnote disclosures normally included in the annual consolidated financial statements prepared in accordance with U.S. GAAP have been condensed or omitted in the accompanying interim condensed consolidated financial statements. In the opinion of the Company’s management, the accompanying unaudited condensed consolidated financial statements 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
Consolidation, Policy [Policy Text Block]	Principles of Consolidation The accompanying condensed consolidated financial statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., Asensus International, Inc., Asensus Surgical Italia S.r.l., Asensus Surgical Europe S.à.r.l., Asensus Surgical Taiwan Ltd., Asensus Surgical Japan K.K., Asensus Surgical Israel Ltd., Asensus Surgical Netherlands B.V., and Asensus Surgical Canada, Inc. All inter-company accounts and transactions have been eliminated in consolidation.
Risk And Uncertainties, Policy [Policy Text Block]	Risk and Uncertainties The Company is subject to risks similar to other similarly sized companies in the medical device industry. These risks include, without limitation: negative impacts on the Company's operations caused by the COVID-19 pandemic; the historical lack of profitability; the Company’s ability to raise additional capital; the success of its market development efforts, 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 company; competition in the market for robotic surgical devices; and its ability to identify and pursue development of additional products.
Use of Estimates, Policy [Policy Text Block]	Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Significant items subject to such estimates and assumptions include impairment considerations for long- term intangible assets, fair value estimates related to contingent consideration, stock compensation expense, revenue recognition, accounts receivable reserves, short-term and long-term investments, excess and obsolete inventory reserves, inventory classification between current and non-current, measurement of lease liabilities and corresponding right-of-use (“ROU”) assets, and deferred tax asset valuation allowances.
Significant Accounting Policies [Policy Text Block]	Significant Accounting Policies There have been no new or material changes to the significant accounting policies discussed in the Company’s audited financial statements and the notes thereto included in the Annual Report on Form 10-K for the fiscal year ended December 31, 2021.
Reclassification, Comparability Adjustment [Policy Text Block]	Reclassifications Certain amounts reported previously have been reclassified to conform to current year presentation, with no effect on stockholders’ equity or net loss as previously reported. These reclassifications relate to revenue and cost of revenue for leases which historically was included in product and service revenue and corresponding cost of revenue on the condensed consolidated statements of operations and comprehensive loss for the three months ended March 31, 2021.
New Accounting Pronouncements, Policy [Policy Text Block]	Impact of Recently Issued Accounting Standards In June 2016, the Financial Accounting Standards Board (“FASB”), issued ASU 2016-13, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, which is designed to provide financial statement users with more information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. The Company adopted ASU 2016-13 as of January 1, 2022, on a modified retrospective basis. The cumulative-effect adjustment related to the adoption was not material. In August 2020, the FASB issued ASU 2020-06, Debt – Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40) guidance on the accounting for convertible debt instruments and contracts in an entity’s own equity. The guidance simplifies the accounting for convertible instruments by reducing the various accounting models that can require the instrument to be separated into a debt component and equity component or derivative component. The Company adopted ASU 2020-06 as of January 1, 2022. The adoption did not have a material impact to the consolidated financial statements. The Company has evaluated all other issued and ASUs not yet adopted and believes the adoption of these standards will not have a material impact on its condensed consolidated statements of operations and comprehensive loss, balance sheets, or statements of cash flows.

Note 3 - Revenue Recognition (Tables)

3 Months Ended

Mar. 31, 2022

Disaggregation of Revenue [Table Text Block]

	Three Months Ended March 31,
	2022		2021
	(in thousands)
U.S.
Systems	$	-	$	3
Instruments and accessories		64		62
Services		74		98
Leases		113		90
Total U.S. revenue		251		253

Outside of U.S. ("OUS")
Systems		-		921
Instruments and accessories		283		377
Services		234		281
Leases		298		251
Total OUS revenue		815		1,830

Total
Systems		-		924
Instruments and accessories		347		439
Services		308		379
Leases		411		341
Total revenue	$	1,066	$	2,083

Contract with Customer, Contract Asset, Contract Liability, and Receivable [Table Text Block]

	As of
	March 31, 2022		December 31, 2021
	(in thousands)
Contract Assets	$	68	$	91
Deferred Revenue	$	533	$	543

Note 4 - Fair Value (Tables)

3 Months Ended

Mar. 31, 2022

Fair Value, Assets Measured on Recurring Basis [Table Text Block]

	March 31, 2022
	(in thousands)

Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents⁽¹⁾	$	24,828	$	-	$	-	$	24,828
Restricted cash		1,176		-		-		1,176
Short-term investments		-		78,913		-		78,913
Long-term investments		-		14,727		-		14,727
Total assets measured at fair value	$	26,004	$	93,640	$	-	$	119,644
Liabilities measured at fair value
Contingent consideration	$	-	$	-	$	2,217	$	2,217
Total liabilities measured at fair value	$	-	$	-	$	2,217	$	2,217

	December 31, 2021
	(in thousands)

Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents⁽¹⁾	$	18,129	$	-	$	-	$	18,129
Restricted cash		1,154		-		-		1,154
Short-term investments		-		80,262		-		80,262
Long-term investments		-		37,435		-		37,435
Total assets measured at fair value	$	19,283	$	117,697	$	-	$	136,980
Liabilities measured at fair value
Contingent consideration	$	-	$	-	$	2,371	$	2,371
Total liabilities measured at fair value	$	-	$	-	$	2,371	$	2,371

Fair Value Measurement Inputs and Valuation Techniques [Table Text Block]

	Valuation Methodology	Significant Unobservable Input	March 31, 2022		December 31, 2021

Contingent consideration	Probability weighted income approach	Milestone dates		2031		2031
		Discount rate		9.5%		9.5%
		Revenue volatility		40.0%		39.0%
		EUR-to-USD exchange rate		1.11		1.14

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]

	Fair Value Measurement at Reporting Date (Level 3)
	(in thousands)
	Series B Warrants			Contingent consideration
Balance at December 31, 2020	$	255		$	3,936
Exercise of warrants		(2,236	)		-
Change in fair value		1,981			257
Balance at March 31, 2021	$	-		$	4,193

Balance at December 31, 2021		-			2,371
Change in fair value		-			(154	)
Balance at March 31, 2022	$	-		$	2,217

Current portion	$	-		$	-
Long-term portion		-			2,217
Balance at March 31, 2022	$	-		$	2,217

Note 5 - Investments, Available-for-sale (Tables)

3 Months Ended

Mar. 31, 2022

Debt Securities, Available-for-Sale [Table Text Block]

	March 31, 2022
	(in thousands)

	Amortized Cost		Unrealized Gain		Unrealized Loss			Fair Value		Short-term investments		Long-term investments
Commercial Paper	$	44,124	$	-	$	(191	)	$	43,933	$	43,933	$	-
Corporate Bonds		50,314		-		(607	)		49,707		34,980		14,727
Total Investments	$	94,438	$	-	$	(798	)	$	93,640	$	78,913	$	14,727

	December 31, 2021
	(in thousands)

	Amortized Cost		Unrealized Gain		Unrealized Loss			Fair Value		Short-term investments		Long-term investments
Commercial Paper	$	50,705	$	-	$	(46	)	$	50,659	$	50,660	$	-
Corporate Bonds		67,239		1		(202	)		67,038		29,602		37,435
Total Investments	$	117,944	$	1	$	(248	)	$	117,697	$	80,262	$	37,435

	March 31, 2022
	(in thousands)
	Amortized Cost		Fair Value
Mature in less than one year	$	79,453	$	78,913
Mature in one to two years		14,985		14,727
Total	$	94,438	$	93,640

Note 6 - Inventories (Tables)

3 Months Ended

Mar. 31, 2022

Schedule of Inventory, Current [Table Text Block]

	March 31, 2022
	(in thousands)

	Gross Carrying Amount		Reserve Balance			Net Carrying Amount
Finished goods	$	11,318	$	(3,061	)	$	8,257
Raw materials		10,811		(2,440	)		8,371
Total inventories	$	22,129	$	(5,501	)	$	16,628

Current Portion	$	10,468	$	(1,327	)	$	9,141
Long-term portion		11,661		(4,174	)		7,487
Total inventories	$	22,129	$	(5,501	)	$	16,628

	December 31, 2021
	(in thousands)

	Gross Carrying Amount		Reserve Balance			Net Carrying Amount
Finished goods	$	10,566	$	(2,987	)	$	7,579
Raw materials		10,824		(2,695	)		8,129
Total inventories	$	21,390	$	(5,682	)	$	15,708

Current Portion	$	9,931	$	(1,297	)	$	8,634
Long-term portion		11,459		(4,385	)		7,074
Total inventories	$	21,390	$	(5,682	)	$	15,708

Note 7 - Intellectual Property (Tables)

3 Months Ended

Mar. 31, 2022

Schedule of Finite-Lived Intangible Assets [Table Text Block]

	March 31, 2022
	(in thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign Currency Translation Impact			Net Carrying Amount
Developed technology	$	68,838	$	(60,086	)	$	(1,954	)	$	6,798
Technology and patents purchased		400		(205	)		16			211
Total intellectual property	$	69,238	$	(60,291	)	$	(1,938	)	$	7,009

	December 31, 2021
	(in thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign Currency Translation Impact			Net Carrying Amount
Developed technology	$	68,838	$	(58,912	)	$	(262	)	$	9,664
Technology and patents purchased		400		(199	)		27			228
Total intellectual property	$	69,238	$	(59,111	)	$	(235	)	$	9,892

Note 8 - Leases (Tables)

3 Months Ended

Mar. 31, 2022

Lease, Cost [Table Text Block]

	Three Months Ended March 31,
	2022		2021
	(in thousands)
Long-term Operating	$	398	$	438
Short-term Operating		-		-
Total Operating lease expense	$	398	$	438

Lessee, Operating Lease, Disclosure [Table Text Block]

	March 31, 2022			December 31, 2021
Weighted-average remaining lease term (in years)		7.7			7.8
Weighted-average discount rate		7.8%			7.8%
Incremental borrowing rate	6.1%	-	8.5%	6.1%	-	8.5%

Lessee, Operating Lease, Liability, Maturity [Table Text Block]

Fiscal Year
2022	$	694
2023		1,008
2024		915
2025		909
2026		845
Thereafter		2,990
Total minimum lease payments	$	7,361
Less: Amount of lease payments representing interest		(1,892	)
Present value of future minimum lease payments	$	5,469

Note 10 - Stock-based Compensation (Tables)

3 Months Ended

Mar. 31, 2022

Share-Based Payment Arrangement, Option, Activity [Table Text Block]

	Number of Shares			Weighted- Average Exercise Price		Weighted-Average Remaining Contractual Term (Years)
Balance at December 31, 2021		4,640,660		$	6.64		5.66
Granted		2,173,832			0.82
Forfeited		(4,155	)		1.71
Cancelled		(13,816	)		38.80
Exercised		(30,001	)		0.41
Balance at March 31, 2022		6,766,520		$	4.74		5.91

Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Vested and Expected to Vest, Exercisable [Table Text Block]

Number of

Shares

Weighted-

Average Exercise

Price

Weighted-Average

Remaining

Contractual Term

(Years)

Aggregate

Intrinsic Value

(Millions)

Exercisable at March 31, 2022

2,392,065

10.06

5.41

0.2

Vested or expected to vest at March 31, 2022

6,421,165

4.91

5.88

0.4

Share-Based Payment Arrangement, Restricted Stock Unit, Activity [Table Text Block]

	Number of Restricted Stock Units Outstanding			Weighted- Average Grant Date Fair Value
Unvested December 31, 2021		3,839,030		$	2.36
Granted		5,133,307			0.80
Vested		(1,603,449	)		2.53
Forfeited		(69,777	)		1.49
Unvested March 31, 2022		7,299,111		$	1.24

Share-Based Payment Arrangement, Cost by Plan [Table Text Block]

	Three Months Ended March 31,
	2022		2021
	(in thousands)
Stock options	$	978	$	1,119
Restricted stock units		883		629
Performance restricted stock units		384		38
	$	2,245	$	1,786

Schedule of Share-Based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]

	Three Months Ended March 31,
	2022			2021
Expected dividend yield		0%			0%
Expected volatility	131%	-	133%	118%	-	136%
Risk-free interest rate	1.25%	-	1.94%	0.33%	-	0.58%
Expected life (in years)	4.3	-	4.5	3.8	-	4.5%

Note 11 - Financing Transactions (Tables)

3 Months Ended

Mar. 31, 2022

Schedule of Sales Under Sales Agency Agreement [Table Text Block]

	Three Months Ended March 31, 2021

Total shares of common stock sold		19,120,037
Average price per share	$	1.47
Gross proceeds	$	28,100
Commission earned by Sales Agents	$	843
Net proceeds	$	27,257

Note 12 - Basic and Diluted Net Loss Per Share (Tables)

3 Months Ended

Mar. 31, 2022

Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block]

	March 31,
	2022		2021
Stock options		6,766,520		4,731,249
Stock warrants		1,120,300		1,323,995
Nonvested restricted stock units		7,299,111		2,688,342
Total		15,185,931		8,743,586

Note 13 - Commitments and Contingencies (Tables)

3 Months Ended

Mar. 31, 2022

Contractual Obligation, Fiscal Year Maturity [Table Text Block]

Fiscal Year
2022	$	6,296
2023		1,304
2024		223
2025		1,201
2026		-
Thereafter		-
Total commitments	$	9,024

Note 14 - Segments and Geographic Areas (Tables)

3 Months Ended

Mar. 31, 2022

Long-Lived Assets by Geographic Areas [Table Text Block]

	March 31, 2022
	Long-Lived Assets			Total Assets
U.S.		30	%		78	%

EMEA
Switzerland		35	%		16	%
Italy		29	%		4	%
Other		6	%		1	%
Total EMEA		70	%		21	%

Asia		0	%		1	%
Total		100	%		100	%

	December 31, 2021
	Long-Lived Assets			Total Assets
U.S.		26	%		77	%

EMEA
Switzerland		34	%		16	%
Italy		36	%		5	%
Other		4	%		1	%
Total EMEA		74	%		22	%

Asia		0	%		1	%
Total		100	%		100	%

Note 3 - Revenue Recognition 1 (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Contract with Customer, Liability, Revenue Recognized	$ 0.2	$ 0.2
Accounts Receivable, Allowance for Credit Loss, Ending Balance	$ 1.8		$ 1.7

Note 3 - Revenue Recognition 2 (Details Textual) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-04-01 $ in Millions	Mar. 31, 2022 USD ($)
Revenue, Remaining Performance Obligation, Amount	$ 2.6
Minimum [Member]
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Period (Year)	1 year
Maximum [Member]
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Period (Year)	4 years

Note 3 - Revenue Recognition - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenue	$ 1,066	$ 2,083
UNITED STATES
Revenue	251	253
Non-US [Member]
Revenue	815	1,830
Systems [Member]
Revenue	0	924
Systems [Member] \| UNITED STATES
Revenue	0	3
Systems [Member] \| Non-US [Member]
Revenue	0	921
Instruments and Accessories [Member]
Revenue	347	439
Instruments and Accessories [Member] \| UNITED STATES
Revenue	64	62
Instruments and Accessories [Member] \| Non-US [Member]
Revenue	283	377
Service [Member]
Revenue	308	379
Service [Member] \| UNITED STATES
Revenue	74	98
Service [Member] \| Non-US [Member]
Revenue	234	281
Lease [Member]
Revenue	411	341
Lease [Member] \| UNITED STATES
Revenue	113	90
Lease [Member] \| Non-US [Member]
Revenue	$ 298	$ 251

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Note 3 - Revenue Recognition - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Contract Assets	$ 68	$ 91
Deferred Revenue	$ 533	$ 543

Note 4 - Fair Value - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - USD ($)
$ in Thousands

Mar. 31, 2022

Dec. 31, 2021

^[1]

$ 24,828

$ 18,129

1,176

1,154

78,913

80,262

14,727

37,435

119,644

136,980

2,217

2,371

Fair Value, Inputs, Level 1 [Member]

2,217

2,371

^[1]

24,828

18,129

1,176

1,154

26,004

19,283

Fair Value, Inputs, Level 2 [Member]

^[1]

78,913

80,262

14,727

37,435

93,640

117,697

Fair Value, Inputs, Level 3 [Member]

^[1]

2,217

2,371

$ 2,217

$ 2,371

[1]	Includes investments that are readily convertible to cash with original maturities of 90 days or less.

Note 4 - Fair Value - Quantitative Information about Inputs and Valuation Methodologies Used for Fair Value Measurements Classification (Details) - Senhance Surgical Robotic System Acquisition[Member] - Fair Value, Inputs, Level 3 [Member]	Mar. 31, 2022	Dec. 31, 2021
Measurement Input, Discount Rate [Member]
Contingent consideration, measurement input	0.095	0.095
Measurement Input, Price Volatility [Member]
Contingent consideration, measurement input	0.400	0.390
Measurement Input, Currency Exchange Rate [Member]
Contingent consideration, measurement input	1.11	1.14

Note 4 - Fair Value - Summary of Change in Fair Value for Warrants and Contingent Consideration (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Warrant [Member]
Balance	$ 0	$ 255
Settlement		(2,236)
Change in fair value	0	1,981
Balance	0	0
Current portion	0
Long-term portion	0
Balance	0	0
Contingent Consideration [Member]
Balance	2,371	3,936
Settlement		0
Change in fair value	(154)	257
Balance	2,217	4,193
Current portion	0
Long-term portion	2,217
Balance	$ 2,217	$ 4,193

Note 5 - Investments, Available-for-sale (Details Textual) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Proceeds from Sale of Debt Securities, Available-for-Sale	$ 0	$ 0

Note 5 - Investments, Available-for-sale - Summary of Investment Securities (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Amortized Cost	$ 94,438	$ 117,944
Unrealized Gain	0	1
Unrealized Loss	(798)	(248)
Fair Value	93,640	117,697
Short-term investments	78,913	80,262
Long-term investments	14,727	37,435
Mature in less than one year, amortized cost	79,453
Mature in less than one year, fair value	78,913
Mature in one to two years, amortized cost	14,985
Mature in one to two years, fair value	14,727
Total, amortized cost	94,438	117,944
Total, fair value	93,640	117,697
Corporate Debt Securities [Member]
Amortized Cost	50,314	67,239
Unrealized Gain	0	1
Unrealized Loss	(607)	(202)
Fair Value	49,707	67,038
Short-term investments	34,980	29,602
Long-term investments	14,727	37,435
Total, amortized cost	50,314	67,239
Total, fair value	49,707	67,038
Commercial Paper [Member]
Amortized Cost	44,124	50,705
Unrealized Gain	0	0
Unrealized Loss	(191)	(46)
Fair Value	43,933	50,659
Short-term investments	43,933	50,660
Long-term investments	0	0
Total, amortized cost	44,124	50,705
Total, fair value	$ 43,933	$ 50,659

Note 6 - Inventories - Components of Inventories (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Finished goods, gross	$ 11,318	$ 10,566
Finished goods, reserve	(3,061)	(2,987)
Finished goods, net	8,257	7,579
Raw materials, gross	10,811	10,824
Raw materials, reserve	(2,440)	(2,695)
Raw materials, net	8,371	8,129
Total inventories, gross	22,129	21,390
Total inventories, reserve	(5,501)	(5,682)
Total inventories, net	16,628	15,708
Current Portion, gross	10,468	9,931
Current Portion, reserve	(1,327)	(1,297)
Inventories	9,141	8,634
Long-term portion, gross	11,661	11,459
Long-term portion, reserve	(4,174)	(4,385)
Inventories, net of current portion	$ 7,487	$ 7,074

Note 7 - Intellectual Property (Details Textual) - Weighted Average [Member]	3 Months Ended
	Mar. 31, 2022
Developed Technology Rights [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	1 year 7 months 6 days
Technology-Based Intangible Assets [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	5 years 1 month 6 days

Note 7 - Intellectual Property - Intellectual Property (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets, Gross	$ 69,238	$ 69,238
Finite-Lived Intangible Assets, Accumulated Amortization	(60,291)	(59,111)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	(1,938)	(235)
Intellectual property, net	7,009	9,892
Developed Technology Rights [Member]
Finite-Lived Intangible Assets, Gross	68,838	68,838
Finite-Lived Intangible Assets, Accumulated Amortization	(60,086)	(58,912)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	(1,954)	(262)
Intellectual property, net	6,798	9,664
Technology-Based Intangible Assets [Member]
Finite-Lived Intangible Assets, Gross	400	400
Finite-Lived Intangible Assets, Accumulated Amortization	(205)	(199)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	16	27
Intellectual property, net	$ 211	$ 228

Note 8 - Leases (Details Textual)	Mar. 31, 2022
Minimum [Member]
Lessee, Operating Lease, Term of Contract (Year)	1 year
Lessee, Operating Lease, Renewal Term (Year)	1 year
Maximum [Member]
Lessee, Operating Lease, Term of Contract (Year)	10 years
Lessee, Operating Lease, Renewal Term (Year)	6 years

Note 8 - Leases - Components of Operating Lease Expense (Details) - General and Administrative Expense [Member] - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Long-term Operating	$ 398	$ 438
Short-term Operating	0	0
Total Operating lease expense	$ 398	$ 438

Note 8 - Leases -Supplemental Balance Sheet Information (Details)	Mar. 31, 2022	Dec. 31, 2021
Weighted-average remaining lease term (in years) (Year)	7 years 8 months 12 days	7 years 9 months 18 days
Weighted-average discount rate	7.80%	7.80%
Minimum [Member]
Incremental borrowing rate	6.10%	6.10%
Maximum [Member]
Incremental borrowing rate	8.50%	8.50%

Note 8 - Leases - Minimum Lease Payments (Details) $ in Thousands	Mar. 31, 2022 USD ($)
2022	$ 694
2023	1,008
2024	915
2025	909
2026	845
Thereafter	2,990
Total minimum lease payments	7,361
Less: Amount of lease payments representing interest	(1,892)
Present value of future minimum lease payments	$ 5,469

Note 9 - Income Taxes (Details Textual) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2022
Effective Income Tax Rate Reconciliation, Percent, Total	(0.40%)	0.20%
Income Tax Expense (Benefit), Total	$ 84	$ (38)
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued, Total	$ 0
Forecast [Member]
Effective Income Tax Rate Reconciliation, Percent, Total			0.30%