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The latest data point for ISRG's EV/EBITDA ratio in Q1'26 stands at 181.96, marking a sharp and anomalous increase from the previous quarter's value of 42.01 in Q4'25, which suggests potential volatility or a significant shift in market valuation metrics. Over the period from Q2'23 to Q1'26, the EV/EBITDA ratio exhibited an overall volatile trend with a general upward trajectory in the earlier phases, peaking at 64.04 in Q3'24 before declining steadily to a low of 42.01 in Q4'25; notable fluctuations include a drop from 52.27 in Q2'23 to 40.26 in Q3'23, followed by recoveries and peaks around 58.68 in Q2'24, indicating sensitivity to operational or market factors in the medical device sector. This area chart highlights periods of expansion in valuation multiples, with the recent Q1'26 spike warranting further investigation into underlying drivers such as earnings adjustments or acquisition impacts.