0001437749-23-023108 | 10-Q | XBRL Viewer

Lessee, Operating Leases [Text Block]

8.	Leases

Lessee Information

Components of operating lease expense recorded in general and administrative expense in the condensed consolidated statements of operations and comprehensive loss were as follows (in thousands):

	Three Months Ended June 30,				Six Months Ended March 31,
	2023		2022		2023		2022

Long-term Operating	$	479	$	386	$	930	$	785

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

	June 30, 2023				December 31, 2022
Weighted-average remaining lease term (in years)			6.4				6.8
Weighted-average discount rate			8.9%				8.4%
Incremental borrowing rate		7.1%	-	16.0%		6.1%	-	14.5%

Maturities of operating lease obligations as of June 30, 2023 were as follows (in thousands):

Fiscal Year
Remainder of 2023	$	577
2024		1,257
2025		1,180
2026		976
2027		896
2028 and thereafter		2,200
Total minimum lease payments	$	7,086
Less: Amount of lease payments representing interest		(1,610	)
Present value of future minimum lease payments	$	5,476

Note 16 - Related Party Transactions (Details Textual) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Asensus Surgical Europe S.à.R.L [Member] \| 1 Med S.A. [Member] \| Service Supply Agreement [Member]
Operating Costs and Expenses	$ 52,000	$ 68,000	$ 71,000	$ 141,000

Note 1 - Description of Business

6 Months Ended

Jun. 30, 2023

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

1.	Description of Business

Asensus Surgical, 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. Based upon the foundations of digital laparoscopy and the Senhance® Surgical System, the Company is developing the LUNA™ Surgical System, a next generation robotic and instrument system as a foundation of its digital surgery solution. These systems will be powered by the Intelligent Surgical Unit™ (ISU™) to increase surgeon’s control and reduce variability of surgical outcomes. With the addition of machine vision, augmented intelligence, and deep learning capabilities throughout the surgical experience, we intend to holistically address the current clinical, cognitive and economic shortcomings that drive surgical outcomes and value-based healthcare. The Company continues market development for and commercialization of the Senhance System, which digitizes laparoscopic minimally invasive surgery, or MIS. The Senhance System is the first 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 11 - Stock-based Compensation (Details Textual) - USD ($) $ in Millions		6 Months Ended
	Jun. 06, 2023	Jun. 30, 2023
Share-Based Payment Arrangement, Option [Member]
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount		$ 2.5
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)		1 year 10 months 24 days
Restricted Stock Units (RSUs) [Member]
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount		$ 6.5
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)		1 year 7 months 6 days
Incentive Compensation Plan [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Additional Shares Authorized (in shares)	22,000,000
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Shares Authorized (in shares)	54,072,307

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

Jun. 30, 2023

Dec. 31, 2022

^[1]

$ 7,675

$ 6,329

1,354

1,141

32,297

64,195

41,326

75,530

1,564

1,256

1,564

1,256

Fair Value, Inputs, Level 1 [Member]

3,865

^[1]

7,675

6,329

1,354

1,141

9,029

7,470

Fair Value, Inputs, Level 2 [Member]

^[1]

32,297

64,195

32,297

68,060

Fair Value, Inputs, Level 3 [Member]

3,865

^[1]

1,564

1,256

$ 1,564

1,256

$ 0

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

Note 15 - Segments and Geographic Areas - Sales by Geographic Area (Details) - Revenue Benchmark [Member] - Geographic Concentration Risk [Member]	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
UNITED STATES
Concentration risk, percent	12.00%	15.00%	16.00%	19.00%
EMEA [Member]
Concentration risk, percent	67.00%	63.00%	62.00%	56.00%
Asia [Member]
Concentration risk, percent	21.00%	22.00%	22.00%	25.00%
All Countries [Member]
Concentration risk, percent	100.00%	100.00%	100.00%	100.00%

Note 11 - Stock-based Compensation - Non-cash Share-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Share-based compensation	$ 1,978	$ 2,083	$ 3,894	$ 4,328
Share-Based Payment Arrangement, Option [Member]
Share-based compensation	591	924	1,256	1,901
Restricted Stock Units (RSUs) [Member]
Share-based compensation	977	822	1,836	1,707
Performance Restricted Stock Unit [Member]
Share-based compensation	$ 410	$ 337	$ 802	$ 720

Note 11 - Stock-based Compensation (Tables)

6 Months Ended

Jun. 30, 2023

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

	Number of Shares			Weighted- Average Exercise Price		Weighted-Average Remaining Contractual Term (Years)		Aggregate Intrinsic Value (Millions)
Outstanding at December 31, 2022		7,584,967		$	4.22		5.31
Granted		3,047,615		$	0.71
Exercised		(13,300	)	$	0.38
Cancelled		(16,762	)	$	27.89
Forfeited		(106	)	$	15.86
Outstanding at June 30, 2023		10,602,414		$	3.18		5.34	$	0.2
Vested or expected to vest at June 30, 2023		10,028,804		$	3.32		5.29	$	0.2
Exercisable at June 30, 2023		5,411,149		$	5.31		4.58	$	0.2

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

	Six Months Ended June 30,
	2023				2022
Expected volatility		124%	-	130%		128%	-	133%
Risk-free interest rate		3.53%	-	4.14%		1.25%	-	2.98%
Expected life (in years)		3.8	-	4.5		4.3	-	4.5
Expected dividend yield			0%				0%
Weighted average grant date fair value	$			0.59	$			0.61

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

	Number of Shares			Weighted- Average Grant Date Fair Value
Outstanding at December 31, 2022		8,483,491		$	1.04
Granted		8,163,060		$	0.72
Vested		(3,355,753	)	$	1.13
Forfeited		(352,110	)	$	0.82
Outstanding at June 30, 2023		12,938,688		$	0.82

Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Table Text Block]

	Three Months Ended June 30,				Six Months Ended June 30,
	2023		2022		2023		2022
	(in thousands)				(in thousands)
Stock options	$	591	$	924	$	1,256	$	1,901
Restricted stock units		977		822		1,836		1,707
Performance restricted stock units		410		337		802		720
	$	1,978	$	2,083	$	3,894	$	4,328

Note 2 - Summary of Significant Accounting Policies (Details Textual) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Retained Earnings (Accumulated Deficit)	$ (903,815)	$ (860,935)
Working Capital	$ 44,300

Amount of accumulated undistributed earnings (deficit).

+ References + Details

Note 10 - Income Taxes

6 Months Ended

Jun. 30, 2023

Income Tax Disclosure [Text Block]

10.

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, 2023. This rate does not include the impact of any discrete items. The Company’s effective tax rate for the three months ended June 30, 2023 and 2022 was 0.1% and (0.4)%, respectively. The Company’s effective tax rate for the six months ended June 30, 2023 and 2022 was (0.2)% and (0.4)%, respectively.

The Company incurred losses for the three and six months ended June 30, 2023, 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, 2023. 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.

The total tax expense during the three months ended June 30, 2023 and 2022, was a benefit of approximately $12,000 and an expense of $85,000, respectively. The total tax expense during the six months ended June 30, 2023 and 2022, was approximately $79,000 and $169,000, respectively.

At June 30, 2023 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 2023; no GILTI tax has been recorded for the six months ended June 30, 2023 or 2022, respectively.

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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-Subparagraph (SAB Topic 11.C)
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

Note 11 - Stock-based Compensation - Stock Option Valuation Assumptions (Details) - $ / shares	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Expected dividend yield	0.00%	0.00%
Weighted average grant date fair value (in dollars per share)	$ 0.59	$ 0.61
Minimum [Member]
Expected volatility	124.00%	128.00%
Risk-free interest rate	3.53%	1.25%
Expected life (in years) (Year)	3 years 9 months 18 days	4 years 3 months 18 days
Maximum [Member]
Expected volatility	130.00%	133.00%
Risk-free interest rate	4.14%	2.98%
Expected life (in years) (Year)	4 years 6 months	4 years 6 months

Note 16 - Related Party Transactions

6 Months Ended

Jun. 30, 2023

16.

Related Party Transactions

In March 2018, Asensus Surgical Europe S.à r.l entered into a Service Supply Agreement with 1 Med S.A. for certain regulatory consulting services. Andrea Biffi, a current member of the Company’s Board of Directors, owns a non-controlling interest in 1 Med S.A. Expenses under the Service Supply Agreement were approximately $52,000 and $68,000 for the three months ended June 30, 2023 and 2022, respectively, and $71,000 and $141,000 for the six months ended June 31, 2023 and 2022, respectively.

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Note 5 - Investments, Available-for-sale

6 Months Ended

Jun. 30, 2023

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

5.	Investments, available-for-sale

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

	June 30, 2023
	(in thousands)

	Amortized Cost		Unrealized Gain		Unrealized Loss			Fair Value		Short-term investments		Long-term investments
Commercial Paper	$	2,986	$	-	$	(5	)	$	2,981	$	2,981	$	-
Corporate Bonds		16,025		-		(83	)		15,942		15,942		-
U.S. Treasuries		12,386		-		(5	)		12,381		12,381		-
U.S. Government Agencies		999		-		(6	)		993		993		-
Total Investments	$	32,396	$	-	$	(99	)	$	32,297	$	32,297	$	-

	December 31, 2022
	(in thousands)

	Amortized Cost		Unrealized Gain		Unrealized Loss			Fair Value		Short-term investments		Long-term investments
Commercial Paper	$	12,364	$	-	$	(49	)	$	12,315	$	12,315	$	-
Corporate Bonds		55,201		-		(447	)		54,754		50,889		3,865
U.S. Government Agencies		999		-		(8	)		991		991		-
Total Investments	$	68,564	$	-	$	(504	)	$	68,060	$	64,195	$	3,865

As of June 30, 2023, contractual maturities of available-for-sale investments were one year or less. 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 or six months ended June 30, 2023 or 2022.

Note 7 - Intellectual Property - Intellectual Property (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets, Gross	$ 69,238	$ 69,238
Finite-Lived Intangible Assets, Accumulated Amortization	(66,991)	(66,801)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	(836)	(861)
Intellectual property, net	1,411	1,576
Developed Technology Rights [Member]
Finite-Lived Intangible Assets, Gross	68,838	68,838
Finite-Lived Intangible Assets, Accumulated Amortization	(66,732)	(66,562)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	(852)	(874)
Intellectual property, net	1,254	1,402
Technology-Based Intangible Assets [Member]
Finite-Lived Intangible Assets, Gross	400	400
Finite-Lived Intangible Assets, Accumulated Amortization	(259)	(239)
Finite-Lived Intangible Assets, Foreign Currency Translation Impact	16	13
Intellectual property, net	$ 157	$ 174

Note 14 - Commitments and Contingencies - Purchase Orders Commitments (Details) - License and Supply Agreement [Member] $ in Thousands	Jun. 30, 2023 USD ($)
2023 (remaining six months)	$ 6,310
2024	1,019
2025	315
2026	303
Total commitments	$ 7,947

Note 5 - Investments, Available-for-sale - Summary of Investment Securities (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Amortized Cost	$ 32,396	$ 68,564
Unrealized Gain	0	0
Unrealized Loss	(99)	(504)
Fair Value	32,297	68,060
Short-term investments	32,297	64,195
Long-term investments	0	3,865
Commercial Paper [Member]
Amortized Cost	2,986	12,364
Unrealized Gain	0	0
Unrealized Loss	(5)	(49)
Fair Value	2,981	12,315
Short-term investments	2,981	12,315
Long-term investments	0	0
Corporate Debt Securities [Member]
Amortized Cost	16,025	55,201
Unrealized Gain	0	0
Unrealized Loss	(83)	(447)
Fair Value	15,942	54,754
Short-term investments	15,942	50,889
Long-term investments	0	3,865
US Treasury Securities [Member]
Amortized Cost	12,386
Unrealized Gain	0
Unrealized Loss	(5)
Fair Value	12,381
Short-term investments	12,381
Long-term investments	0
US Government Agencies Debt Securities [Member]
Amortized Cost	999	999
Unrealized Gain	0	0
Unrealized Loss	(6)	(8)
Fair Value	993	991
Short-term investments	993	991
Long-term investments	$ 0	$ 0

Note 4 - Fair Value

6 Months Ended

Jun. 30, 2023

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):

	June 30, 2023
	(in thousands)

Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents⁽¹⁾	$	7,675	$	-	$	-	$	7,675
Restricted cash		1,354		-		-		1,354
Short-term investments		-		32,297		-		32,297
Total assets measured at fair value	$	9,029	$	32,297	$	-	$	41,326
Liabilities measured at fair value
Contingent consideration	$	-	$	-	$	1,564	$	1,564
Total liabilities measured at fair value	$	-	$	-	$	1,564	$	1,564

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

	December 31, 2022
	(in thousands)

Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents⁽¹⁾	$	6,329	$	-	$	-	$	6,329
Restricted cash		1,141		-		-		1,141
Short-term investments		-		64,195		-		64,195
Long-term investments		-		3,865		-		3,865
Total assets measured at fair value	$	7,470	$	68,060	$	-	$	75,530
Liabilities measured at fair value
Contingent consideration	$	-	$	-	$	1,256	$	1,256
Total liabilities measured at fair value	$	-	$	-	$	1,256	$	1,256

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

The carrying values of accounts receivable, prepaid expenses, employee retention tax credit receivable, other current assets, accounts payable, accrued employee compensation and benefits, accrued expenses and other current liabilities, and deferred revenue as of June 30, 2023, and December 31, 2022, approximate their fair values due to the short-term nature of these items.

The Company’s financial liabilities measured at fair value on a recurring basis consisted of contingent consideration payable to Three Heads Investment S.r.l., related to the Company’s 2015 acquisition of the Senhance System from an assignor to Three Heads Investment S.r.l. (the “Senhance Acquisition”). Adjustments associated with the change in fair value of contingent consideration are included in the Company’s 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 June 30, 2023 and December 31, 2022:

	Valuation Methodology	Significant Unobservable Input	June 30, 2023		December 31, 2022

Contingent consideration	Probability weighted income approach	Milestone dates	2032		2032
		Discount rate		15.0%		16.5%
		Revenue volatility		45.0%		45.0%
		EUR-to-USD exchange rate		1.09		1.07

The following table presents the current and long-term portion of the contingent consideration as of June 30, 2023 and summarizes the change in fair value, as determined by Level 3 inputs for the contingent consideration for the six months ended June 30, 2023:

	Fair Value Measurement at Reporting Date (Level 3)
	(in thousands)
	Contingent consideration
Balance at December 31, 2022	$	1,256
Change in fair value		308
Balance at June 30, 2023	$	1,564

Reported as:
Current portion	$	-
Long-term portion		1,564
Balance at June 30, 2023	$	1,564

During the six months ended June 30, 2023, there were no transfers of assets or liabilities between Level 1, Level 2, or Level 3 of fair value categories.

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 8 - Leases - Minimum Lease Payments (Details) $ in Thousands	Jun. 30, 2023 USD ($)
Remainder of 2023	$ 577
2024	1,257
2025	1,180
2026	976
2027	896
2028 and thereafter	2,200
Total minimum lease payments	7,086
Less: Amount of lease payments representing interest	(1,610)
Present value of future minimum lease payments	$ 5,476

Note 7 - Intellectual Property (Tables)

6 Months Ended

Jun. 30, 2023

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

	June 30, 2023
	(in thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign Currency Translation Impact			Net Carrying Amount
Developed technology	$	68,838	$	(66,732	)	$	(852	)	$	1,254
Technology and patents purchased		400		(259	)		16			157
Total intellectual property	$	69,238	$	(66,991	)	$	(836	)	$	1,411

	December 31, 2022
	(in thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign Currency Translation Impact			Net Carrying Amount
Developed technology	$	68,838	$	(66,562	)	$	(874	)	$	1,402
Technology and patents purchased		400		(239	)		13			174
Total intellectual property	$	69,238	$	(66,801	)	$	(861	)	$	1,576

Note 12 - Equity Offerings (Details Textual) - The 2022 ATM Offering [Member] $ in Billions	Mar. 18, 2022 USD ($)
Stock Offering Agreement, Maximum Share Value	$ 0.1
Stock Offering Agreement, Commission, Percent	3.00%

Note 2 - Summary of Significant Accounting Policies

6 Months Ended

Jun. 30, 2023

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 Year 2022 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.

Going Concern

The Company's condensed consolidated financial statements are prepared using U.S. GAAP applicable to a going concern basis of accounting, which contemplate the realization of assets and liquidation of liabilities in the normal course of business. The Company had an accumulated deficit of $903.8 million and working capital of $44.3 million as of June 30, 2023. The Company has not established sufficient sales revenues to cover its operating costs and requires additional capital to proceed with its operating plan. The ability of the Company to continue as a going concern is dependent on the Company obtaining adequate capital to fund operating losses until it becomes profitable.

The Company will need to obtain additional financing to execute its business plan. Management's plan to obtain additional resources for the Company may include additional sales of equity, traditional financing, such as loans, entry into strategic collaborations, entry into an out-licensing arrangement or provision of additional distribution rights in some or all of its markets. However, management cannot provide any assurance that the Company will be successful in accomplishing any or all of its plans. The ability to successfully resolve these factors raise substantial doubt about the Company’s ability to meet its existing obligations, and to continue as a going concern within one year from the date that these financial statements are issued. The condensed consolidated financial statements of the Company do not include any adjustments that may result from the outcome of these aforementioned uncertainties.

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: the historical lack of profitability; the Company’s ability to raise additional capital; its ability to successfully develop, clinically test and commercialize its products and products in development; negative impacts on the Company's operations caused by the COVID-19 pandemic and other geopolitical factors; the success of its market development efforts; the timing and outcome of the regulatory review process for its products; changes in the healthcare regulatory environments of the United States, the European Union, Japan, Taiwan, and other countries in which the Company operates or intends to operate; its ability to attract and retain key management, marketing and scientific personnel; its ability to successfully prepare, file, prosecute, maintain, defend and enforce patent claims and other intellectual property rights; its ability to successfully transition from a research and development company to a marketing, sales and distribution company; competition in the market for robotic surgical devices; and its ability to identify and pursue development of additional products.

Use of Estimates

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

Significant Accounting Policies

There have been no new or material changes to the significant accounting policies discussed in the Company’s audited financial statements and the notes thereto included in the Fiscal Year 2022 Form 10-K.

Impact of Recently Issued Accounting Standards

The Company has evaluated issued ASUs not yet adopted and believes the adoption of these standards will not have a material impact on its consolidated financial statements.

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Operating Activities:
Net loss	$ (42,880)	$ (38,747)
Adjustments to reconcile net loss to net cash and cash equivalents used in operating activities:
Depreciation	1,652	1,720
Amortization of intangible assets	226	5,203
Amortization of discounts and premiums on investments, net	(298)	444
Stock-based compensation	3,894	4,328
Deferred tax expense	79	169
Bad debt expense	0	9
Change in inventory reserves	459	(567)
Property and equipment impairment	0	432
Loss on disposal of property and equipment	0	97
Change in fair value of contingent consideration	308	(752)
Changes in operating assets and liabilities:
Accounts receivable	1,614	(8)
Inventory	(1,240)	(1,933)
Operating lease right-of-use assets	40	409
Prepaid expenses	409	189
Other current and long-term assets	340	(1,169)
Accounts payable	961	524
Accrued employee compensation and benefits	(577)	(284)
Accrued expenses and other current liabilities	(55)	0
Deferred revenue	(94)	(4)
Operating lease liabilities	(42)	(290)
Net cash and cash equivalents used in operating activities	(35,204)	(30,230)
Investing Activities:
Purchase of available-for-sale investments	(12,268)	(17,792)
Proceeds from maturities of available-for-sale investments	48,735	41,408
Purchase of property and equipment	(166)	(443)
Net cash and cash equivalents provided by investing activities	36,301	23,173
Financing Activities:
Proceeds from issuance of common stock, net of issuance costs	196	0
Taxes paid related to net share settlement of vesting of restricted stock units	(490)	(349)
Proceeds from exercise of stock options	5	18
Net cash and cash equivalents used in financing activities	(289)	(331)
Effect of exchange rate changes on cash and cash equivalents	751	239
Net increase (decrease) in cash, cash equivalents and restricted cash	1,559	(7,149)
Cash, cash equivalents and restricted cash, beginning of period	7,470	19,283
Cash, cash equivalents and restricted cash, end of period	9,029	12,134
Supplemental Disclosure for Cash Flow Information
Cash paid for leases	655	549
Cash paid for taxes	262	65
Supplemental Schedule of Non-cash Investing and Financing Activities:
Transfer of inventory to property and equipment	802	724
Lease liabilities arising from obtaining right-of-use assets	$ 417	$ 0

Note 8 - Leases -Supplemental Balance Sheet Information (Details)	Jun. 30, 2023	Dec. 31, 2022
Weighted-average remaining lease term (in years) (Year)	6 years 4 months 24 days	6 years 9 months 18 days
Weighted-average discount rate	8.90%	8.40%
Minimum [Member]
Incremental borrowing rate	7.10%	6.10%
Maximum [Member]
Incremental borrowing rate	16.00%	14.50%

Note 12 - Equity Offerings

6 Months Ended

Jun. 30, 2023

Equity Offerings [Text Block]

12.

Equity Offerings

2022 ATM Offering

On March 18, 2022, the Company entered into a Controlled Equity Offering Sales Agreement (the “2022 Sales Agreement”) with Cantor Fitzgerald & Co. (“Cantor”) and Oppenheimer & Co. Inc. (“Oppenheimer”), collectively, “the Agents”. The Company commenced an at-the-market offering (the “2022 ATM Offering”) pursuant to which the Company could offer and sell, from time to time, at its option, shares of its common stock for an aggregate offering price of up to $100.0 million. The aggregate compensation payable to the Agents was 3.0% of the aggregate gross proceeds from each sale of the Company’s common stock.

The following table presents details about common stock issued pursuant to the 2022 ATM Offering (in thousands, except share and per share amounts):

	For the Three Months Ended June 30, 2023			For the Six Months Ended June 30, 2023
Shares of common stock issued		355,072			355,072
Average price per share	$	0.57		$	0.57
Gross proceeds	$	202		$	202
Commission paid to Agents	$	(6	)	$	(6	)
Net proceeds	$	196		$	196

Note 10 - Income Taxes (Details Textual) - USD ($)	3 Months Ended		6 Months Ended
Note 10 - Income Taxes (Details Textual) - USD ($)	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2023	Jun. 30, 2023	Jun. 30, 2022
Effective Income Tax Rate Reconciliation, Percent	0.10%	(0.40%)		(0.20%)	(0.40%)
Income Tax Expense (Benefit)	$ (12,000)	$ 85,000		$ 79,000	$ 169,000
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued, Total	$ 0			$ 0
Forecast [Member]
Effective Income Tax Rate Reconciliation, Percent			(0.30%)

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

Note 11 - Stock-based Compensation - RSU Activity (Details) - Restricted Stock Units (RSUs) [Member]	6 Months Ended
	Jun. 30, 2023 $ / shares shares
Beginning of period, Restricted stock units, Unvested (in shares) \| shares	8,483,491
Beginning of period, Restricted stock units, Unvested, weighted average grant date fair value (in dollars per share) \| $ / shares	$ 1.04
Restricted stock units, Granted (in shares) \| shares	8,163,060
Restricted stock units, Granted, weighted average grant date fair value (in dollars per share) \| $ / shares	$ 0.72
Restricted stock units, Vested (in shares) \| shares	(3,355,753)
Restricted stock units, Vested, weighted average grant date fair value (in dollars per share) \| $ / shares	$ 1.13
Restricted stock units, Forfeited (in shares) \| shares	(352,110)
Restricted stock units, Forfeited, weighted average grant date fair value (in dollars per share) \| $ / shares	$ 0.82
Beginning of period, Restricted stock units, Unvested (in shares) \| shares	12,938,688
Beginning of period, Restricted stock units, Unvested, weighted average grant date fair value (in dollars per share) \| $ / shares	$ 0.82

Note 3 - Revenue Recognition - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Revenue	$ 1,081	$ 994	$ 2,057	$ 2,060
UNITED STATES
Revenue	133	144	339	395
Non-US [Member]
Revenue	948	850	1,718	1,665
Systems [Member]
Revenue	0	0	0	0
Systems [Member] \| UNITED STATES
Revenue	0	0	0	0
Systems [Member] \| Non-US [Member]
Revenue	0	0	0	0
Instruments and Accessories [Member]
Revenue	298	254	591	601
Instruments and Accessories [Member] \| UNITED STATES
Revenue	38	18	98	82
Instruments and Accessories [Member] \| Non-US [Member]
Revenue	260	236	493	519
Service [Member]
Revenue	289	424	484	732
Service [Member] \| UNITED STATES
Revenue	76	75	151	149
Service [Member] \| Non-US [Member]
Revenue	213	349	333	583
Lease [Member]
Revenue	494	316	982	727
Lease [Member] \| UNITED STATES
Revenue	19	51	90	164
Lease [Member] \| Non-US [Member]
Revenue	$ 475	$ 265	$ 892	$ 563

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
-Topic 924
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
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-Publisher FASB
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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 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
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-URI https://asc.fasb.org//1943274/2147482810/280-10-50-41

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Paragraph 4
-Subparagraph (a)
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-URI https://asc.fasb.org//1943274/2147479806/606-10-50-4

Note 17 - Subsequent Events

6 Months Ended

Jun. 30, 2023

Subsequent Events [Text Block]

17.

Subsequent Events

On July 27, 2023, the Company sold, in a registered direct offering, an aggregate of 23,809,524 shares of common stock and accompanying warrants to purchase one share of common stock at a combined purchase price of $0.42 per share. The Company expects to receive aggregate gross proceeds from the offering of $10.0 million, before deducting approximately $0.9 million of placement agent’s fees and estimated offering expenses. The warrants have an exercise price of $0.42 per share, are immediately exercisable and will expire five years following the date of issuance.

Note 6 - Inventory

6 Months Ended

Jun. 30, 2023

Inventory Disclosure [Text Block]

6.	Inventory

The components of inventory are as follows:

	June 30, 2023
	(in thousands)
	Gross Carrying Amount		Reserve Balance			Net Carrying Amount
Finished goods	$	15,899	$	(4,221	)	$	11,678
Raw materials		4,770		(2,426	)		2,344
Total inventory	$	20,669	$	(6,647	)	$	14,022

Current Portion	$	10,318	$	(1,235	)	$	9,083
Long-term portion		10,351		(5,412	)		4,939
Total inventory	$	20,669	$	(6,647	)	$	14,022

	December 31, 2022
	(in thousands)
	Gross Carrying Amount		Reserve Balance			Net Carrying Amount
Finished goods	$	15,337	$	(4,129	)	$	11,208
Raw materials		4,718		(2,173	)		2,545
Total inventory	$	20,055	$	(6,302	)	$	13,753

Current Portion	$	9,399	$	(1,115	)	$	8,284
Long-term portion		10,656		(5,187	)		5,469
Total inventory	$	20,055	$	(6,302	)	$	13,753

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares	Jun. 30, 2023	Dec. 31, 2022
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	750,000,000	750,000,000
Common stock, shares issued (in shares)	239,970,041	236,895,440
Common stock, shares outstanding (in shares)	239,970,041	236,895,440
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	25,000,000	25,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0

Note 3 - Revenue Recognition - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Contract Assets	$ 70	$ 116
Deferred Revenue	$ 376	$ 465

Significant Accounting Policies (Policies)	6 Months Ended
Significant Accounting Policies (Policies)	Jun. 30, 2023
Accounting Policies [Abstract]
Basis of Accounting, Policy [Policy Text Block]	Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and include the accounts of the Company and its direct and indirect wholly owned subsidiaries. All inter-company accounts and transactions have been eliminated in consolidation. The results reported in these unaudited interim condensed consolidated financial statements should not 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 Year 2022 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.
Substantial Doubt about Going Concern [Policy Text Block]	Going Concern The Company's condensed consolidated financial statements are prepared using U.S. GAAP applicable to a going concern basis of accounting, which contemplate the realization of assets and liquidation of liabilities in the normal course of business. The Company had an accumulated deficit of $903.8 million and working capital of $44.3 million as of June 30, 2023. The Company has not established sufficient sales revenues to cover its operating costs and requires additional capital to proceed with its operating plan. The ability of the Company to continue as a going concern is dependent on the Company obtaining adequate capital to fund operating losses until it becomes profitable. The Company will need to obtain additional financing to execute its business plan. Management's plan to obtain additional resources for the Company may include additional sales of equity, traditional financing, such as loans, entry into strategic collaborations, entry into an out-licensing arrangement or provision of additional distribution rights in some or all of its markets. However, management cannot provide any assurance that the Company will be successful in accomplishing any or all of its plans. The ability to successfully resolve these factors raise substantial doubt about the Company’s ability to meet its existing obligations, and to continue as a going concern within one year from the date that these financial statements are issued. The condensed consolidated financial statements of the Company do not include any adjustments that may result from the outcome of these aforementioned uncertainties.
Consolidation, Policy [Policy Text Block]	Principles of Consolidation 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.
Use of Estimates, Policy [Policy Text Block]	Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Significant items subject to such estimates and assumptions include impairment considerations for long-lived assets, fair value estimates related to contingent consideration, stock-based compensation expense, revenue recognition, short-term and long-term investments, excess and obsolete inventory reserves, inventory classification between current and non-current, measurement of lease liabilities and corresponding right-of-use (“ROU”) assets, and deferred tax asset valuation allowances.
New Accounting Pronouncements, Policy [Policy Text Block]	Impact of Recently Issued Accounting Standards The Company has evaluated issued ASUs not yet adopted and believes the adoption of these standards will not have a material impact on its consolidated financial statements.

Note 6 - Inventory - Components of Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Finished goods, gross	$ 15,899	$ 15,337
Finished goods, reserve	(4,221)	(4,129)
Finished goods, net	11,678	11,208
Raw materials, gross	4,770	4,718
Raw materials, reserve	(2,426)	(2,173)
Raw materials, net	2,344	2,545
Total inventory, gross	20,669	20,055
Total inventory, reserve	(6,647)	(6,302)
Total inventory, net	14,022	13,753
Current Portion, gross	10,318	9,399
Current Portion, reserve	(1,235)	(1,115)
Inventory	9,083	8,284
Long-term portion, gross	10,351	10,656
Long-term portion, reserve	(5,412)	(5,187)
Inventory, net of current portion	$ 4,939	$ 5,469

Note 3 - Revenue Recognition 1 (Details Textual) $ in Millions	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)
Contract with Customer, Liability, Revenue Recognized	$ 0.1	$ 0.3	$ 0.3	$ 0.5
Accounts Receivable, Allowance for Credit Loss	$ 1.6		$ 1.6		$ 1.6
Customer Concentration Risk [Member] \| Accounts Receivable [Member]
Number of Major Customers			2		1
Customer Concentration Risk [Member] \| Accounts Receivable [Member] \| Customer One [Member]
Concentration Risk, Percentage			43.00%
Customer Concentration Risk [Member] \| Accounts Receivable [Member] \| Customer Two [Member]
Concentration Risk, Percentage			13.00%
Customer Concentration Risk [Member] \| Accounts Receivable [Member] \| Customer Three [Member]
Concentration Risk, Percentage					69.00%

Note 3 - Revenue Recognition 2 (Details Textual) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2023-07-01 $ in Millions	Jun. 30, 2023 USD ($)
Revenue, Remaining Performance Obligation, Amount	$ 0.8
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 8 - Leases (Tables)

6 Months Ended

Jun. 30, 2023

Lease, Cost [Table Text Block]

	Three Months Ended June 30,				Six Months Ended March 31,
	2023		2022		2023		2022

Long-term Operating	$	479	$	386	$	930	$	785

Lessee, Operating Lease, Disclosure [Table Text Block]

	June 30, 2023				December 31, 2022
Weighted-average remaining lease term (in years)			6.4				6.8
Weighted-average discount rate			8.9%				8.4%
Incremental borrowing rate		7.1%	-	16.0%		6.1%	-	14.5%

Lessee, Operating Lease, Liability, to be Paid, Maturity [Table Text Block]

Fiscal Year
Remainder of 2023	$	577
2024		1,257
2025		1,180
2026		976
2027		896
2028 and thereafter		2,200
Total minimum lease payments	$	7,086
Less: Amount of lease payments representing interest		(1,610	)
Present value of future minimum lease payments	$	5,476

Note 13 - Basic and Diluted Net Loss Per Share - Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	24,562,178	16,218,148
Share-Based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	10,602,414	7,112,573
Warrant [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	1,021,076	1,120,300
Restricted Stock Units (RSUs) [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares)	12,938,688	7,985,275

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

6 Months Ended

Jun. 30, 2023

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

	June 30, 2023
	(in thousands)

	Amortized Cost		Unrealized Gain		Unrealized Loss			Fair Value		Short-term investments		Long-term investments
Commercial Paper	$	2,986	$	-	$	(5	)	$	2,981	$	2,981	$	-
Corporate Bonds		16,025		-		(83	)		15,942		15,942		-
U.S. Treasuries		12,386		-		(5	)		12,381		12,381		-
U.S. Government Agencies		999		-		(6	)		993		993		-
Total Investments	$	32,396	$	-	$	(99	)	$	32,297	$	32,297	$	-

	December 31, 2022
	(in thousands)

	Amortized Cost		Unrealized Gain		Unrealized Loss			Fair Value		Short-term investments		Long-term investments
Commercial Paper	$	12,364	$	-	$	(49	)	$	12,315	$	12,315	$	-
Corporate Bonds		55,201		-		(447	)		54,754		50,889		3,865
U.S. Government Agencies		999		-		(8	)		991		991		-
Total Investments	$	68,564	$	-	$	(504	)	$	68,060	$	64,195	$	3,865

Tabular disclosure of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-9

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aa)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aaa)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Note 13 - Basic and Diluted Net Loss Per Share (Tables)

6 Months Ended

Jun. 30, 2023

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

	June 30,
	2023		2022
Stock options		10,602,414		7,112,573
Stock warrants		1,021,076		1,120,300
Nonvested restricted stock units		12,938,688		7,985,275
Total		24,562,178		16,218,148

Condensed Consolidated Statements of Operations and Comprehensive Loss (Unaudited) - USD ($) shares in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Revenue:
Revenue	$ 1,081,000	$ 994,000	$ 2,057,000	$ 2,060,000
Cost of revenue:
Cost of revenue	3,074,000	2,347,000	6,021,000	4,170,000
Gross loss	(1,993,000)	(1,353,000)	(3,964,000)	(2,110,000)
Operating expenses:
Research and development	8,980,000	7,253,000	19,119,000	13,681,000
Sales and marketing	4,449,000	3,602,000	9,002,000	7,321,000
General and administrative	5,124,000	4,992,000	10,592,000	10,525,000
Amortization of intangible assets	114,000	2,533,000	226,000	5,203,000
Change in fair value of contingent consideration	203,000	(598,000)	308,000	(752,000)
Property and equipment impairment	0	432,000	0	432,000
Total operating expenses	18,870,000	18,214,000	39,247,000	36,410,000
Operating loss	(20,863,000)	(19,567,000)	(43,211,000)	(38,520,000)
Interest income	431,000	260,000	870,000	515,000
Interest expense	0	(141,000)	0	(341,000)
Other expense, net	(242,000)	(86,000)	(460,000)	(232,000)
Total other income (expense), net	189,000	33,000	410,000	(58,000)
Loss before income taxes	(20,674,000)	(19,534,000)	(42,801,000)	(38,578,000)
Income tax benefit (expense)	12,000	(85,000)	(79,000)	(169,000)
Net loss	$ (20,662,000)	$ (19,619,000)	$ (42,880,000)	$ (38,747,000)
Net loss per common share attributable to common stockholders - basic and diluted (in dollars per share)	$ (0.09)	$ (0.08)	$ (0.18)	$ (0.16)
Weighted average number of shares used in computing net loss per common share - basic and diluted (in shares)	239,570	236,505	238,929	236,201
Comprehensive loss:
Net loss	$ (20,662,000)	$ (19,619,000)	$ (42,880,000)	$ (38,747,000)
Foreign currency translation gain (loss)	175,000	(1,713,000)	725,000	(2,363,000)
Unrealized gain (loss) on available-for-sale investments	99,000	(144,000)	406,000	(696,000)
Comprehensive loss	(20,388,000)	(21,476,000)	(41,749,000)	(41,806,000)
Product [Member]
Revenue:
Revenue	298,000	254,000	591,000	601,000
Cost of revenue:
Cost of revenue	1,612,000	883,000	2,837,000	1,259,000
Service [Member]
Revenue:
Revenue	289,000	424,000	484,000	732,000
Cost of revenue:
Cost of revenue	519,000	646,000	1,268,000	1,141,000
Lease [Member]
Revenue:
Revenue	494,000	316,000	982,000	727,000
Cost of revenue:
Cost of revenue	$ 943,000	$ 818,000	$ 1,916,000	$ 1,770,000

Note 7 - Intellectual Property

6 Months Ended

Jun. 30, 2023

Intangible Assets Disclosure [Text Block]

7.	Intellectual Property

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

	June 30, 2023
	(in thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign Currency Translation Impact			Net Carrying Amount
Developed technology	$	68,838	$	(66,732	)	$	(852	)	$	1,254
Technology and patents purchased		400		(259	)		16			157
Total intellectual property	$	69,238	$	(66,991	)	$	(836	)	$	1,411

	December 31, 2022
	(in thousands)
	Gross Carrying Amount		Accumulated Amortization			Foreign Currency Translation Impact			Net Carrying Amount
Developed technology	$	68,838	$	(66,562	)	$	(874	)	$	1,402
Technology and patents purchased		400		(239	)		13			174
Total intellectual property	$	69,238	$	(66,801	)	$	(861	)	$	1,576

The weighted average remaining useful life of the developed technology and technology and patents purchased was 3.7 years and 3.8 years, respectively, as of June 30, 2023. The weighted average remaining useful life of the developed technology and technology and patents purchased was 4.2 years and 4.3 years, respectively as of December 31, 2022.

Note 8 - Leases - Components of Operating Lease Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
General and Administrative Expense [Member]
Long-term Operating	$ 479	$ 386	$ 930	$ 785

Note 11 - Stock-based Compensation - Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Millions	6 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
Options, Outstanding, Number of Shares (in shares)	7,584,967
Options, Outstanding, Weighted Average Exercise Price (in dollars per share)	$ 4.22
Options, Outstanding, Weighted Average Remaining Contractual Term (Year)	5 years 4 months 2 days	5 years 3 months 21 days
Options, Granted, Number of Shares (in shares)	3,047,615
Options, Grants in Period, Weighted Average Exercise Price (in dollars per share)	$ 0.71
Options, Exercised, Number of Shares (in shares)	(13,300)
Options, Exercises in Period, Weighted Average Exercise Price (in dollars per share)	$ 0.38
Options, Cancelled, Number of Shares (in shares)	(16,762)
Options, Expirations in Period, Weighted Average Exercise Price (in dollars per share)	$ 27.89
Options, Forfeited, Number of Shares (in shares)	(106)
Options, Forfeitures in Period, Weighted Average Exercise Price (in dollars per share)	$ 15.86
Options, Outstanding, Number of Shares (in shares)	10,602,414	7,584,967
Outstanding at June 30, 2023 (in dollars per share)	$ 3.18	$ 4.22
Options, Outstanding, Aggregate Intrinsic Value	$ 0.2
Options, Vested and Expected to Vest, Exercisable, Number of Shares (in shares)	10,028,804
Options, Vested and Expected to Vest, Exercisable, Weighted Average Exercise Price (in dollars per share)	$ 3.32
Options, Vested and Expected to Vest, Exercisable, Weighted Average Remaining Contractual Term (Year)	5 years 3 months 14 days
Options, Vested or Expected to Vest, Aggregate Intrinsic Value	$ 0.2
Options, Exercisable, Number of Shares (in shares)	5,411,149
Options, Exercisable, Weighted Average Exercise Price (in dollars per share)	$ 5.31
Options, Exercisable, Weighted Average Remaining Contractual Term (Year)	4 years 6 months 29 days
Options, Exercisable, Aggregate Intrinsic Value	$ 0.2

Note 15 - Segments and Geographic Areas - Consolidated Assets and Long Lived Assets by Geographic Area (Details) - Geographic Concentration Risk [Member] - Long-lived Assets [Member]	6 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
UNITED STATES
Percentage	38.00%	39.00%
EMEA [Member]
Percentage	60.00%	57.00%
Asia [Member]
Percentage	2.00%	4.00%
All Countries [Member]
Percentage	100.00%	100.00%

Note 14 - Commitments and Contingencies

6 Months Ended

Jun. 30, 2023

Commitments and Contingencies Disclosure [Text Block]

14.

Commitments and Contingencies

License and Supply Agreements

The Company has purchase orders with various suppliers for certain tooling, supplies, contract engineering and research services. Commitments related to these agreements and purchase orders are as follows (in thousands):

Fiscal Year
2023 (remaining six months)	$	6,310
2024		1,019
2025		315
2026		303
Total commitments	$	7,947

Note 12 - Equity Offerings - Summary of Sales Under Offering (Details) - USD ($) $ / shares in Units, $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Net proceeds	$ 196	$ 0
The 2022 ATM Offering [Member]
Shares of common stock issued (in shares)	355,072	355,072
Gross proceeds	$ 202	$ 202
Commission paid to Agents	6	6
Net proceeds	$ 196	$ 196
The 2022 ATM Offering [Member] \| Arithmetic Average [Member]
Average price per share (in dollars per share)	$ 0.57	$ 0.57

Note 5 - Investments, Available-for-sale (Details Textual) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Proceeds from Sale of Debt Securities, Available-for-Sale	$ 0	$ 0	$ 0	$ 0

Note 6 - Inventory (Tables)

6 Months Ended

Jun. 30, 2023

Schedule of Inventory, Current [Table Text Block]

	June 30, 2023
	(in thousands)
	Gross Carrying Amount		Reserve Balance			Net Carrying Amount
Finished goods	$	15,899	$	(4,221	)	$	11,678
Raw materials		4,770		(2,426	)		2,344
Total inventory	$	20,669	$	(6,647	)	$	14,022

Current Portion	$	10,318	$	(1,235	)	$	9,083
Long-term portion		10,351		(5,412	)		4,939
Total inventory	$	20,669	$	(6,647	)	$	14,022

	December 31, 2022
	(in thousands)
	Gross Carrying Amount		Reserve Balance			Net Carrying Amount
Finished goods	$	15,337	$	(4,129	)	$	11,208
Raw materials		4,718		(2,173	)		2,545
Total inventory	$	20,055	$	(6,302	)	$	13,753

Current Portion	$	9,399	$	(1,115	)	$	8,284
Long-term portion		10,656		(5,187	)		5,469
Total inventory	$	20,055	$	(6,302	)	$	13,753

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]	Jun. 30, 2023	Dec. 31, 2022
Milestone Date, Year [Member]
Contingent consideration milestone dates	Dec. 31, 2032	Dec. 31, 2032
Measurement Input, Discount Rate [Member]
Contingent consideration, measurement input	0.150	0.165
Measurement Input, Price Volatility [Member]
Contingent consideration, measurement input	0.450	0.450
Measurement Input, Currency Exchange Rate [Member]
Contingent consideration, measurement input	1.09	1.07

Note 9 - Accrued Expenses

6 Months Ended

Jun. 30, 2023

Accrued Liabilities [Text Block]

9.	Accrued Expenses

Accrued expenses and other current liabilities consisted of the following (in thousands):

	June 30, 2023		December 31, 2022
Income and other taxes payable	$	680	$	839
Legal and professional fees		326		275
Royalties		118		24
Consulting services		160		155
Total accrued expenses and other current liabilities	$	1,284	$	1,293

Note 4 - Fair Value - Summary of Change in Fair Value for Warrants and Contingent Consideration (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
Balance	$ 1,256
Change in fair value	308
Balance	1,564
Current portion	0
Long-term portion	$ 1,564	$ 1,256

Note 15 - Segments and Geographic Areas (Tables)

6 Months Ended

Jun. 30, 2023

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

	June 30, 2023			December 31, 2022
U.S.		38	%		39	%
EMEA		60	%		57	%
Asia		2	%		4	%
Total		100	%		100	%

Revenue from External Customers by Geographic Areas [Table Text Block]

	Three Months Ended June 30,						Six Months Ended June 30,
	2023			2022			2023			2022


US		12	%		15	%		16	%		19	%
EMEA		67	%		63	%		62	%		56	%
Asia		21	%		22	%		22	%		25	%
Total		100	%		100	%		100	%		100	%

Note 3 - Revenue Recognition

6 Months Ended

Jun. 30, 2023

Revenue from Contract with Customer [Text Block]

3.	Revenue Recognition

The following table presents revenue disaggregated by type and geography:

	Three Months Ended June 30,				Six Months Ended June 30,
	2023		2022		2023		2022
	(in thousands)				(in thousands)
U.S.
Systems	$	-	$	-	$	-	$	-
Instruments and accessories		38		18		98		82
Services		76		75		151		149
Leases		19		51		90		164
Total U.S. revenue		133		144		339		395

Outside of U.S. ("OUS")
Systems		-		-		-		-
Instruments and accessories		260		236		493		519
Services		213		349		333		583
Leases		475		265		892		563
Total OUS revenue		948		850		1,718		1,665

Total
Systems		-		-		-		-
Instruments and accessories		298		254		591		601
Services		289		424		484		732
Leases		494		316		982		727
Total revenue	$	1,081	$	994	$	2,057	$	2,060

Remaining Performance Obligations

The transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which the revenue has not yet been recognized. A significant portion of this amount relates to service obligations performed under the Company's system sales contracts that will be invoiced and recognized as revenue in future periods. The transaction price allocated to remaining performance obligations as of June 30, 2023 was $0.8 million, which is expected to be recognized over one to four years.

Contract Assets and Liabilities

Deferred revenue for the periods presented was primarily related to service obligations, for which the service fees are billed up-front, generally annually. The associated deferred revenue is generally recognized ratably over the service period. The Company did not have any significant impairment losses on its contract assets (included in accounts receivable, net in the consolidated balance sheets) for the periods presented.

Revenue recognized for the three months ended June 30, 2023 and 2022 that was included in the deferred revenue balance at the beginning of each reporting period was $0.1 million and $0.3 million, respectively. Revenue recognized for the six months ended June 30, 2023 and 2022 that was included in the deferred revenue balance at the beginning of each reporting period was $0.3 million and $0.5 million, respectively.

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

	As of
	June 30, 2023		December 31, 2022
	(in thousands)
Contract Assets	$	70	$	116
Deferred Revenue	$	376	$	465

Senhance System Leasing

The Company enters into lease arrangements with certain qualified customers. Revenue related to arrangements including lease elements are allocated to lease and non-lease elements based on their relative standalone selling prices. Lease elements generally include a Senhance System, while non-lease elements generally include instruments, accessories, and services. For some lease arrangements, the customers are provided with the right to purchase the leased Senhance System at some point during and/or at the end of the lease term. In some arrangements lease payments are based on the usage of the Senhance System. For the three and six months ended June 30, 2023, and 2022, variable lease revenue related to usage-based arrangements was not material.

Accounts Receivable

Accounts receivable are recorded at net realizable value, which includes an allowance for expected credit losses. The allowance for expected credit losses is based on the Company’s assessment of the collectability of customer accounts. The Company regularly reviews the allowance by considering factors such as historical experience, credit quality, the age of the accounts receivable balances, and current economic conditions that may affect a customer’s ability to pay. The allowance for expected credit losses was $1.6 million and $1.6 million as of June 30, 2023 and December 31, 2022, respectively. The Company recorded immaterial amounts for expected credit losses during the three and six months ended June 30, 2023 and 2022.

The Company had two customers that accounted for 43% and 13%, respectively, of the Company’s net accounts receivable as of June 30, 2023. The Company had one customer that accounted for 69% of the Company’s net accounts receivable as of December 31, 2022.

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.

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
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Note 15 - Segments and Geographic Areas

6 Months Ended

Jun. 30, 2023

Segment Reporting Disclosure [Text Block]

15.

Segments and Geographic Areas

The Company operates in one business segment—the research, development, and sale of medical devices to improve minimally invasive surgery. The Company’s chief operating decision maker (determined to be the Chief Executive Officer) does not 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 long-lived assets (which include property and equipment and operating lease assets) by geographic area:

	June 30, 2023			December 31, 2022
U.S.		38	%		39	%
EMEA		60	%		57	%
Asia		2	%		4	%
Total		100	%		100	%

The following table presents revenue by geographic area based on the country in which the customer is based:

	Three Months Ended June 30,						Six Months Ended June 30,
	2023			2022			2023			2022


US		12	%		15	%		16	%		19	%
EMEA		67	%		63	%		62	%		56	%
Asia		21	%		22	%		22	%		25	%
Total		100	%		100	%		100	%		100	%

For the three and six months ended June 30, 2023, no customers accounted for more than 10% of revenue. For the three months ended June 30, 2022, the Company had one customer who accounted for 10% of revenue. For the six months ended June 30, 2022, no customers accounted for more than 10% of revenue.

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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Note 14 - Commitments and Contingencies (Tables)

6 Months Ended

Jun. 30, 2023

Contractual Obligation, Fiscal Year Maturity [Table Text Block]

Fiscal Year
2023 (remaining six months)	$	6,310
2024		1,019
2025		315
2026		303
Total commitments	$	7,947

Note 15 - Segments and Geographic Areas (Details Textual)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Number of Operating Segments			1
Revenue Benchmark [Member] \| Customer Concentration Risk [Member]
Number of Major Customers	0	1	0	0
Revenue Benchmark [Member] \| Customer Concentration Risk [Member] \| One Customer [Member]
Concentration Risk, Percentage		10.00%

Note 13 - Basic and Diluted Net Loss Per Share

6 Months Ended

Jun. 30, 2023

Earnings Per Share [Text Block]

13.

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 basic weighted average outstanding common shares figures for the three and six months ended June 30, 2023 or 2022 as the assumed exercise of outstanding options, warrants and restricted stock units would be anti-dilutive.

Potential common shares not included in the computation of diluted net loss per share are as follows:

	June 30,
	2023		2022
Stock options		10,602,414		7,112,573
Stock warrants		1,021,076		1,120,300
Nonvested restricted stock units		12,938,688		7,985,275
Total		24,562,178		16,218,148

Note 4 - Fair Value (Tables)

6 Months Ended

Jun. 30, 2023

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

	June 30, 2023
	(in thousands)

Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents⁽¹⁾	$	7,675	$	-	$	-	$	7,675
Restricted cash		1,354		-		-		1,354
Short-term investments		-		32,297		-		32,297
Total assets measured at fair value	$	9,029	$	32,297	$	-	$	41,326
Liabilities measured at fair value
Contingent consideration	$	-	$	-	$	1,564	$	1,564
Total liabilities measured at fair value	$	-	$	-	$	1,564	$	1,564

	December 31, 2022
	(in thousands)

Description	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets measured at fair value
Cash and cash equivalents⁽¹⁾	$	6,329	$	-	$	-	$	6,329
Restricted cash		1,141		-		-		1,141
Short-term investments		-		64,195		-		64,195
Long-term investments		-		3,865		-		3,865
Total assets measured at fair value	$	7,470	$	68,060	$	-	$	75,530
Liabilities measured at fair value
Contingent consideration	$	-	$	-	$	1,256	$	1,256
Total liabilities measured at fair value	$	-	$	-	$	1,256	$	1,256

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

	Valuation Methodology	Significant Unobservable Input	June 30, 2023		December 31, 2022

Contingent consideration	Probability weighted income approach	Milestone dates	2032		2032
		Discount rate		15.0%		16.5%
		Revenue volatility		45.0%		45.0%
		EUR-to-USD exchange rate		1.09		1.07

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

	Fair Value Measurement at Reporting Date (Level 3)
	(in thousands)
	Contingent consideration
Balance at December 31, 2022	$	1,256
Change in fair value		308
Balance at June 30, 2023	$	1,564

Reported as:
Current portion	$	-
Long-term portion		1,564
Balance at June 30, 2023	$	1,564

Condensed Consolidated Statements of Changes in Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Common Stock [Member]	Treasury Stock, Common [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Total
Balance (in shares) at Dec. 31, 2021	235,219,000	0
Balance at Dec. 31, 2021	$ 235	$ 0	$ 954,649	$ (785,374)	$ (264)	$ 169,246
Stock-based compensation	$ 0	$ 0	2,245	0	0	2,245
Exercise of stock options (in shares)	30,000	0
Exercise of stock options	$ 0	$ 0	12	0	0	12
Issuance of common stock related to vesting of restricted stock units (in shares)	1,166,000	0
Issuance of common stock related to vesting of restricted stock units	$ 1	$ 0	0	0	0	1
Shares withheld related to net share settlement of equity awards (in shares)	0	436,000
Shares withheld related to net share settlement of equity awards	$ 0	$ 0	(349)	0	0	(349)
Cancellation of treasury stock (in shares)	0	(436,000)
Cancellation of treasury stock	$ 0	$ 0	0	0	0	(0)
Cancellation of treasury stock	0	0	0	0	0	0
Other comprehensive income (loss)	0	0	0	0	(1,202)	(1,202)
Net loss	$ 0	$ 0	0	(19,128)	0	(19,128)
Balance (in shares) at Mar. 31, 2022	236,415,000	0
Balance at Mar. 31, 2022	$ 236	$ 0	956,557	(804,502)	(1,466)	150,825
Balance (in shares) at Dec. 31, 2021	235,219,000	0
Balance at Dec. 31, 2021	$ 235	$ 0	954,649	(785,374)	(264)	169,246
Net loss						(38,747)
Balance (in shares) at Jun. 30, 2022	236,620,000	0
Balance at Jun. 30, 2022	$ 237	$ 0	958,646	(824,121)	(3,323)	131,439
Balance (in shares) at Mar. 31, 2022	236,415,000	0
Balance at Mar. 31, 2022	$ 236	$ 0	956,557	(804,502)	(1,466)	150,825
Stock-based compensation	$ 0	$ 0	2,083	0	0	2,083
Exercise of stock options (in shares)	13,000	0
Exercise of stock options	$ 0	$ 0	6	0	0	6
Issuance of common stock related to vesting of restricted stock units (in shares)	192,000	0
Issuance of common stock related to vesting of restricted stock units	$ 1	$ 0	0	0	0	1
Other comprehensive income (loss)	0			0	(1,857)	(1,857)
Net loss	$ 0	$ 0	0	(19,619)	0	(19,619)
Balance (in shares) at Jun. 30, 2022	236,620,000	0
Balance at Jun. 30, 2022	$ 237	$ 0	958,646	(824,121)	(3,323)	131,439
Balance (in shares) at Dec. 31, 2022	236,895,000	0
Balance at Dec. 31, 2022	$ 237	$ 0	962,731	(860,935)	(2,388)	99,645
Stock-based compensation	$ 0		1,916	0	0	1,916
Exercise of stock options (in shares)	13,000	0
Exercise of stock options	$ 0	$ 0	5	0	0	5
Issuance of common stock related to vesting of restricted stock units (in shares)	2,434,000	0
Issuance of common stock related to vesting of restricted stock units	$ 2	$ 0	0	0	0	2
Shares withheld related to net share settlement of equity awards (in shares)	0	649,000
Shares withheld related to net share settlement of equity awards	$ 0	$ 1	(490)	0	0	(489)
Cancellation of treasury stock (in shares)	0	(649,000)
Cancellation of treasury stock	$ 0	$ (1)	0	0	0	1
Cancellation of treasury stock	0	1	0	0	0	(1)
Other comprehensive income (loss)	0	0	0	0	857	857
Net loss	$ 0	$ 0		(22,218)	0	(22,218)
Balance (in shares) at Mar. 31, 2023	239,342,000	0
Balance at Mar. 31, 2023	$ 239	$ 0	964,162	(883,153)	(1,531)	79,717
Balance (in shares) at Dec. 31, 2022	236,895,000	0
Balance at Dec. 31, 2022	$ 237	$ 0	962,731	(860,935)	(2,388)	$ 99,645
Exercise of stock options (in shares)						13,300
Net loss						$ (42,880)
Balance (in shares) at Jun. 30, 2023	239,970,000	0
Balance at Jun. 30, 2023	$ 240	$ 0	966,335	(903,815)	(1,257)	61,503
Balance (in shares) at Mar. 31, 2023	239,342,000	0
Balance at Mar. 31, 2023	$ 239	$ 0	964,162	(883,153)	(1,531)	79,717
Stock-based compensation	$ 0	$ 0	1,978	0	0	1,978
Issuance of common stock related to vesting of restricted stock units (in shares)	273,000	0
Issuance of common stock related to vesting of restricted stock units	$ 0	$ 0	0	0	0	0
Other comprehensive income (loss)	0	0	0	0	274	274
Net loss	$ 0	$ 0	0	(20,662)	0	(20,662)
Issuance of common stock, net of issuance costs (in shares)	355,000	0
Issuance of common stock, net of issuance costs	$ 1	$ 0	195	0	0	196
Balance (in shares) at Jun. 30, 2023	239,970,000	0
Balance at Jun. 30, 2023	$ 240	$ 0	$ 966,335	$ (903,815)	$ (1,257)	$ 61,503

Note 17 - Subsequent Events (Details Textual) - Subsequent Event [Member] $ / shares in Units, $ in Millions	Jul. 27, 2023 USD ($) $ / shares shares
Warrants Issued in Registered Direct Offering [Member]
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares) \| shares	1
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) \| $ / shares	$ 0.42
Warrants and Rights Outstanding, Term (Year)	5 years
Common Stock Issued in Registered Direct Offering [Member]
Stock Issued During Period, Shares, New Issues (in shares) \| shares	23,809,524
Equity Offering, Combined Price Per Share (in dollars per share) \| $ / shares	$ 0.42
Proceeds from Issuance or Sale of Equity \| $	$ 10.0
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs \| $	$ 0.9

Note 3 - Revenue Recognition (Tables)

6 Months Ended

Jun. 30, 2023

Disaggregation of Revenue [Table Text Block]

	Three Months Ended June 30,				Six Months Ended June 30,
	2023		2022		2023		2022
	(in thousands)				(in thousands)
U.S.
Systems	$	-	$	-	$	-	$	-
Instruments and accessories		38		18		98		82
Services		76		75		151		149
Leases		19		51		90		164
Total U.S. revenue		133		144		339		395

Outside of U.S. ("OUS")
Systems		-		-		-		-
Instruments and accessories		260		236		493		519
Services		213		349		333		583
Leases		475		265		892		563
Total OUS revenue		948		850		1,718		1,665

Total
Systems		-		-		-		-
Instruments and accessories		298		254		591		601
Services		289		424		484		732
Leases		494		316		982		727
Total revenue	$	1,081	$	994	$	2,057	$	2,060

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

	As of
	June 30, 2023		December 31, 2022
	(in thousands)
Contract Assets	$	70	$	116
Deferred Revenue	$	376	$	465

Document And Entity Information - shares	6 Months Ended
Document And Entity Information - shares	Jun. 30, 2023	Aug. 07, 2023
Document Information [Line Items]
Entity Central Index Key	0000876378
Entity Registrant Name	ASENSUS SURGICAL, INC.
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	Q2
Document Fiscal Year Focus	2023
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2023
Document Transition Report	false
Entity File Number	0-19437
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	11-2962080
Entity Address, Address Line One	1 TW Alexander Drive, Suite 160
Entity Address, City or Town	Durham
Entity Address, State or Province	NC
Entity Address, Postal Zip Code	27703
City Area Code	919
Local Phone Number	765-8400
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common Stock $0.001 par value per share
Trading Symbol	ASXC
Security Exchange Name	NYSEAMER
Entity Common Stock, Shares Outstanding		263,874,871

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Current Assets:
Cash and cash equivalents	$ 7,675	$ 6,329
Short-term investments, available-for-sale	32,297	64,195
Accounts receivable, net	660	2,256
Inventory	9,083	8,284
Prepaid expenses	3,149	3,584
Employee retention tax credit receivable	554	554
Other current assets	1,492	1,671
Total Current Assets	54,910	86,873
Restricted cash	1,354	1,141
Long-term investments, available-for-sale	0	3,865
Inventory, net of current portion	4,939	5,469
Property and equipment, net	8,815	9,542
Intellectual property, net	1,411	1,576
Net deferred tax assets	155	174
Operating lease right-of-use assets, net	4,888	4,950
Other long-term assets	1,899	2,463
Total Assets	78,371	116,053
Current Liabilities:
Accounts payable	4,281	3,348
Accrued employee compensation and benefits	3,887	4,508
Accrued expenses and other current liabilities	1,284	1,293
Operating lease liabilities - current portion	819	800
Deferred revenue	376	465
Total Current Liabilities	10,647	10,414
Long-Term Liabilities:
Contingent consideration	1,564	1,256
Noncurrent operating lease liabilities	4,657	4,738
Total Liabilities	16,868	16,408
Commitments and Contingencies (Note 14)
Stockholders' Equity:
Common stock $0.001 par value, 750,000,000 shares authorized at June 30, 2023 and December 31, 2022; 239,970,041 and 236,895,440 issued and outstanding at June 30, 2023 and December 31, 2022, respectively	240	237
Preferred stock, $0.01 par value, 25,000,000 shares authorized, no shares issued and outstanding at June 30, 2023 and December 31, 2022	0	0
Additional paid-in capital	966,335	962,731
Accumulated deficit	(903,815)	(860,935)
Accumulated other comprehensive loss	(1,257)	(2,388)
Total Stockholders' Equity	61,503	99,645
Total Liabilities and Stockholders' Equity	78,371	116,053
Intellectual Property [Member]
Current Assets:
Intellectual property, net	$ 1,411	$ 1,576

Note 12 - Equity Offerings (Tables)

6 Months Ended

Jun. 30, 2023

Schedule of Common Stock Outstanding Roll Forward [Table Text Block]

	For the Three Months Ended June 30, 2023			For the Six Months Ended June 30, 2023
Shares of common stock issued		355,072			355,072
Average price per share	$	0.57		$	0.57
Gross proceeds	$	202		$	202
Commission paid to Agents	$	(6	)	$	(6	)
Net proceeds	$	196		$	196

Note 7 - Intellectual Property (Details Textual) - Weighted Average [Member]	Jun. 30, 2023	Dec. 31, 2022
Developed Technology Rights [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	3 years 8 months 12 days	4 years 2 months 12 days
Technology-Based Intangible Assets [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	3 years 9 months 18 days	4 years 3 months 18 days

Note 9 - Accrued Expenses - Components of Accrued Expenses (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Income and other taxes payable	$ 680	$ 839
Legal and professional fees	326	275
Royalties	118	24
Consulting services	160	155
Total accrued expenses and other current liabilities	$ 1,284	$ 1,293

Note 11 - Stock-based Compensation

6 Months Ended

Jun. 30, 2023