Good afternoon, ladies and gentlemen, and welcome to the Apollo Endosurgery 1/3 1/4 2022 results call. At this time, all participants have been placed on a Listen-Only Mode, and we will open the floor for your questions and comments after the presentation. It is now my pleasure to turn the floor over to your host, Matt Kreps. Sir, the floor is yours. Thank you, John, and thanks everyone for participating in today's call to discuss Apollo's 1/3 1/4 2022 financial and operating results. Joining me on the call are Chas McKhann, Chief Executive Officer, and Jeffrey Black, our Chief Financial Officer. Today's call will include Slides to accompany the audio presentation. For those of you who are joining us by telephone, you can download a copy of the Slides at our investor relations site, ir.apolloendo.com and choosing the Events and Presentations tab. Before we begin, I'd like to caution listeners that comments made by management during this conference call will include Forward-Looking statements within the meaning of Federal Securities laws, including Apollo's financial outlook and Apollo's plans and timing for product development and sales. In addition, there is uncertainty about the continuing effects of the COVID-19 pandemic, the macroeconomic conditions and the impact it may have on our operations, the demand for our products, global supply chains, and economic activity in general. These Forward-Looking statements involve material risks and uncertainties, and Apollo's actual results may differ materially. For a discussion of risk factors, I encourage you to review the company's most recent annual report on Form 10-K and our most recent Form 10-Q. The content of this conference call contains time-sensitive information that is accurate only as of the date of this live broadcast, November 1, 2022. Except as required by law, Apollo undertakes no obligation to revise or update any statement to reflect events or circumstances after the day of this call. Additionally, today's discussion will include certain Non-GAAP financial measures, which we believe provide an additional tool for evaluating the company's core performance. Management uses these metrics in its own evaluations of continuing operating performance and a baseline for assessing the future earnings potential of the company. Included in the press release issued today with our financial results and corresponding 8-K filing are supplemental tables reconciling Non-GAAP figures to their closest GAAP comparable. Now I'd like to turn the call over to Chas. Thanks, Matt. Good afternoon, everyone, and thank you very much for joining us. I'm very pleased to report that in Q3, we achieved another quarterly record with nearly $20 million in sales. We've increased our revenue guidance for the year, and in operational terms, we anticipate achieving approximately 25% growth for the year in constant currency. Apollo's business is heading in the right direction. Importantly, our 2022 growth is occurring in advance of four big growth drivers that we're going to discuss on the call. Seizing the endobariatric opportunity with the launch of Apollo ESG and Revise, continue to scale our commercial channel, especially in the US. The exciting launch of a new product, OverStitch NXT, which we have not disclosed publicly before, but I will describe later on the call. Then some new large growth opportunities in markets outside the US. Before we speak about those, let me talk about the 1/4. Slide 4 includes some highlights from some of the key metrics for the 1/4. 24% growth Year-Over-Year in constant currency, and 45% growth in ESS. As a reminder, that is the combination of both OverStitch and X-Tack. We have publicly discussed that we really view those 2 products as our primary growth drivers in the portfolio, and I think 45% growth is indicative of that. We continue to see excellent depth in our top accounts. Our top 10 accounts worldwide have grown 80% Year-Over-Year as they continue to expand usage of Apollo's products. X-Tack is doing very well. It has grown essentially doubled Year-Over-Year. As we mentioned in the press release, X-Tack is now the number 2 product in our portfolio in the United States. This is now our 7th consecutive 1/4 of revenue growth. These are some of the operational highlights. In addition, we had 2 very important strategic milestones through the 1/4, which we talked about on our prior call. Those being the FDA marketing authorization for Apollo ESG and Apollo Revise, as well as the publication of the MERIT study in The Lancet. I'm thrilled with the results that we achieved in Q3. I am very thankful for the tireless efforts of members of the Apollo team that have allowed us to achieve them. With that, I'll hand over to Jeffrey to provide an update on our financial results, and I'll come back and talk about some of the opportunities we have to build on these successes. Thank you, Chas, and thank you, everybody, for joining us today. Just to get started on Slide 6 with revenue, as Chas reported, another record 1/4 of strong Year-Over-Year growth, our 7th consecutive 1/4 of double-digit growth. For the second consecutive 1/4, we achieved the highest revenue on record for Apollo on both a GAAP and constant currency basis. Globally, our ESS portfolio was up by nearly $5 million, grew 45% in constant currency. It grew by about $4 million and 41% on a GAAP basis. In the U.S., we grew revenue by 29% with our ESS portfolio up nearly $3 million and 41%. This growth in ESS is reflective of continued impact of our planned investments, particularly around salesforce expansion and our increased productivity of the salesforce. ESS volume increases were the primary drivers of the growth. We did see a moderate impact from price increases. The growth in ESS was led primarily by OverStitch adoption in our endobariatric accounts. We also saw, as Chas mentioned, increasing contribution from X-Tack in our defect closure accounts. Orbera, which is our intragastric balloon, was down for the 1/4 by about $200,000, and that's due to summer seasonality and macroeconomic conditions. In the US, we grew revenue by 18% on a constant currency basis, 9% on a GAAP basis, with our ESS portfolio up nearly $2 million and 53% in constant currency. OUS, we saw strong procedural volumes for OverStitch with some price offset due to a higher distributor revenue mix. We saw a similar dynamic OUS for Orbera as we experienced in the US, where volumes were down due to seasonality and macroeconomic conditions, which we do believe is likely impacting some patient decisions about whether or not to get a balloon procedure. We've communicated in prior quarters that Orbera is a strategic asset for us in our endobariatric growth strategy. We continue to believe that Orbera will be a stable to low to mid-single-digit grower, both in the US and internationally. We did see significant foreign currency headwinds, which had a nearly $700,000 impact or 900 basis points on Year-Over-Year growth. We're disproportionately impacted by foreign currency pressures compared to similarly sized med tech companies because of our large OUS footprint relative to our peers. Moving to Slide 7 on guidance. As we look at the outlook for the rest of the year, we increased today, as you saw in the press release, our full year 2022 guidance to $75 million-$76 million, and that's really on the strength of our Q3 performance. This implies full year growth of 19%-21%, second 1/2 Year-Over-Year growth of 20%-23% on a GAAP basis compared to first 1/2 growth of 18%. On a constant currency basis, this implies growth of up to 25%, which is above our medium term 20% growth outlook that we have communicated previously. We have a number of positive growth drivers in Q4 and heading into 2023. With that said, as we set guidance for the remainder of the year, we do remain cognizant of the continued potential global macroeconomic impacts, especially from inflation, continued foreign currency pressures, particularly for the euro, which currently represents nearly 1/2 of our OUS direct revenue. Again, potential seasonality later in the fourth 1/4 in our endobariatric accounts, which represent a growing mix of our total revenue. Moving to margin on Slide 8. We remain on track with our margin expansion targets, although we did see impacts of both foreign currency and product mix in the 1/3 1/4. Gross margin was flat in the 1/3 1/4 on a constant currency basis versus prior year, and down about 150 basis points on a GAAP basis. We continue to see overall COGS reduction in our ESS product line from the impact of 2021 OverStitch COGS improvement projects, as well as improved overhead efficiencies. Offsetting these improvements were a lower revenue mix from Orbera, which has a higher gross margin profile. We also saw a higher revenue mix across the portfolio from our OUS distributor channel, and that typically has a lower gross margin profile than our direct channel. As we look to Q4 this year and beyond 2022, there are a number of factors that we believe will drive gross margin expansion. First of all, we recently made a decision to increase prices in both OUS and U.S. markets. The gross margin benefits of these recent price increases should begin to show up in the next 1-2 quarters, and we also expect future price increases to contribute to incremental gross margin expansion over time. Beyond the price increases, there are still a number of major drivers of overall margin expansion, including improved overhead absorption and direct COGS improvement programs, which are focused primarily on OverStitch. Several of these are already underway. We continue to navigate supply chain manufacturing scale-up complexities, and we remain confident in our ability to drive margin in the Mid-60% range in the medium term. Moving to our operating expense profile, on a Non-GAAP basis, we do think it's important to take a look at our expense run rate on a Non-GAAP basis, excluding Non-cash stock-based compensation. As we stated before, 2022 is a planned investment year for Apollo, with a targeted focus on building capabilities to drive both near and long-term growth for our existing portfolio. The most significant area of that investment continues to be sales and marketing in the US, which ran at about 42% of revenue in the second 1/4. It reflects our expanding US sales channel and marketing programs as we prepare for the anticipated launch of Apollo ESG and Revise. In total, our Non-GAAP expenses were 75% of total revenue in our most recent 1/4. That's down from 80% in the second 1/4, and this is reflective of improved sales force productivity and the timing of some marketing spend. Given the current environment, we continue to be careful stewards of our resources. Through the first 3 quarters of 2022, we're well below our OpEx and CapEx spend plans while on target with our revenue plans. Perhaps most importantly, we're well positioned from a balance sheet perspective to support these growth initiatives. With that, addressing our balance sheet on Slide 10. At the end of Q3, we had over $130 million in cash and committed cash. That includes about $68 million in cash and cash equivalents and access to another $40 million over 2023 and 2024 based upon revenue milestones, which are well below our base case expectations. We've seen operating cash use continue to improve throughout 2022. The increases in cash use have been primarily working capital for inventory builds and CapEx to support revenue growth. Really, thanks to the diligence of our entire operations team, we've been able to successfully manage a number of supply chain complexities, mitigate risk, secure raw material supply, and begin to build inventories to more appropriate levels given our midterm forecast. We expect to end the year with $125 million in cash and committed cash, including about $60 million in cash and equivalents, and this implies cash use for the year of around $30 million, which we still continue to anticipate as our high watermark for annual cash burn based upon our base case model. Again, we've got a multi-year cash runway to execute the plan as we stand here today, a clear line of sight to a cash flow breakeven business and a balance sheet with committed capital to get us there. With that, I'll turn the call back over to Chas. Thank you, Jeffrey. On my first call with investors last spring, I laid out a plan that had 3 phases to it. We really were focusing at that time on a first phase of energizing the business, then moving into an accelerate phase, and then leading in the markets that we serve. Slide 13 provides a little bit of a scorecard, as it were, of how we've done during that first energize phase, a little over a year. People within Apollo know that I place a very high premium on delivering on our commitments. Let's talk about how we've done. In terms of strategic milestones, we said that X-Tack was going to be an important new product that delivers exceptional clinical value. It is now the number 2 product in the US in our portfolio and adoption continues to grow. We said that we were pursuing FDA authorization for the ESG procedure and for endoscopic revisions. Those were granted in July. We said that we believe that the MERIT study represented a fundamental step forward in the field of endobariatric, and that the study was worthy of publication in a top-tier journal. MERIT was published in The Lancet, also in July. Then all the while, we've been undergoing a financial transformation. If you compare our growth in the 1/4 that we just announced, and compare it to Q4 of 2020, and the reason that was a 1/4 right before I took over as CEO, our growth in that period is 52%. Apollo is rapidly becoming a growth company. All the while, we've strengthened the balance sheet, and as Jeffrey mentioned, have a very clear pathway towards cash flow breakeven. In addition, we've been revitalizing the organization at all levels. On the leadership and the board, we've made some significant additions. I particularly want to highlight again the recent additions of Jeannette Banks, who's a senior executive at Alcon, and Sharon O'Keefe, the former president of the University of Chicago Medical Center, to our board of directors. Jeannette and Sharon have added tremendous amount of value already in this short period of time, just fresh new perspectives on our board and adding to an already very strong team, and we are thrilled to have them. We've also been building key functional capabilities and critical mass in the organization. We've highlighted a few on the Slide in R&D, in reimbursement and health economics, and in marketing, and we continue to expand our sales team, and we're hiring some of the best in the industry as we do so. Apollo is entirely a different company than we were just a little over a year ago. Now we turn our attention to the next phase, the accelerate phase. I'm very pleased to talk about four opportunities today that are either in the very early stages or are brand new, that will help drive that accelerate phase. You see them on the Slide. I referenced them earlier, the endobariatric opportunity, growing our commercial channel, expanding access to suturing with OverStitch NXT, and then pursuing significant expansion opportunities outside the U.S. Let's walk through them and starting with the endobariatric side. Slide 15 is a repeat of a Slide we showed on the August call, and I'm including it again because I think it makes a really important point. That is that ESG is entirely different than anything else that has come before in the field of endoscopic bariatric procedures. No other procedure has the combination of an FDA authorization, level one clinical evidence, and then delivers a combination of effectiveness, safety, and very good durability. The market is already starting to respond to that, right? Slide 16 shows results in 20 of our top accounts in the U.S., our top 10 private practices and our top 10 academic medical centers that primarily do endobariatric procedures. That combined group of 20 accounts year to date are up 50% Year-Over-Year in terms of their performance. Importantly, among the private practices, that group will average over 500 procedures with Apollo products between ESGs, bariatric revisions, and/or variable procedures, an average of more than 500 each this year. Clearly, we're gaining adoption in these initial pioneering accounts. One of the true pioneers in this space is a physician named Dr. Chris McGowan, who's based in North Carolina. H e is the founder and leader of True You Weight Loss. They've recently opened a new location in Atlanta. Two weeks ago, Dr. McGowan did a live case presentation of his 2000th ESG procedure. That's not a typo. In a few short years, Dr. McGowan personally has done 2000 ESGs. He did a live case that was presented on YouTube and other social media platforms, pardon me. The case video is available online and it's excellent. In less than an hour, while conducting a flawless ESG procedure, Dr. McGowan answered questions about ESG. His answers are clear, they are balanced, and they are intended for a lay audience interested in learning more about the procedure. Some of the topics he covered are included on the right-hand of the Slide. I won't go through all of them except to highlight a few. The average total body weight loss in Dr. McGowan's practice is 20%-21%. Their safety profile is excellent, with an average adverse event rate of 0.1%. The procedures are typically done in an outpatient setting in a same-day procedure, and patients can return to work within 3-5 business days. If you have an interest in learning more about ESG, or if you've got family members or colleagues or friends who'd like to know more about the procedure, I do encourage you to look online, and there is a link on page 17. Dr. McGowan is a gastroenterologist who really now specializes in endobariatric procedures. In addition, and importantly, bariatric surgeons are also starting to embrace ESG. Slide 18 describes the experience of Dr. Brandon VanderWeele that was presented in August at the IFSO meeting, which is a big international conference, and it was in Miami this year. VanderWeele is a bariatric surgeon who practices outside of Seattle, and he presented these data at the conference that in, again, only about 2 years, he started offering ESG, and he had 469 new patient consults specifically because people heard about ESG. Out of those, he really found 2 things. First of all, that ESG could absolutely help him treat more patients and expand his practice. Almost 200 of those interested people who came in the door got an ESG procedure, and about 100 of them received a laparoscopic sleeve. The biggest reason why people would get a laparoscopic sleeve were 2fold, those with higher BMIs as well as insurance. All of Dr. VanderWeele's ESGs are cash pay procedures. Despite that, from a 2-to-1 ratio, people were getting ESGs over laparoscopic procedures. The second thing that was really meaningful about Dr. VanderWeele's presentation is just the outcomes he's achieving. 24% total body weight loss at 12 months. He and his team do an excellent job with the procedure and are very rigorous in their aftercare and patient Follow-UP, and you can see the results in their outcomes. We are just in the very early days of patient understanding and awareness about ESG, and patient stories are just starting to emerge, and you see some examples on page 19. I'll highlight just the one on the left because it's a pretty remarkable story. This was a woman in South Carolina who underwent an ESG procedure and lost a lot of weight, and in doing so, actually discovered a lump in her throat that was diagnosed and turned out to be cancerous. They caught it early, were able to intervene, and my understanding is she's doing very well. Just the impact is so gratifying to see. I am the son of a physician. I come from a medical family. Patient care is in my familial DNA. These kind of patient impact stories really are what drive me and I think drive our team in how we move forward. We will actually be adding additional patient marketing and patient awareness activities here starting this 1/4. More to follow as those get launched here in the coming weeks. I mentioned some of the early adopters, the practices that are absolutely having success with endobariatric. Our next stage, obviously, is training, right? Training the next wave of people, both surgeons and GIs. I'm pleased to report that we have already completed one course in October and have another one scheduled in December with a total of about 50 physicians. We've got plans for similar courses for at least 100 physicians next year. Importantly, these are experienced physicians. Most of them already have suturing skills with OverStitch and now have a strong interest in developing an endobariatric program. We also have an outstanding group of faculty. Some of the faculty members across the already scheduled programs are shown on the page, on page 20. That includes 3 GIs with Dr. Dr. Gostout, our Chief Medical Officer, Dr. Thacker and Dr. Charbel, as well as 2 surgeons, Dr. Ujiki and Dr. Snow. We've got a mix of private practice and academic. And so a whole range of perspectives, not only on the technical aspects of having the best possible patient outcomes with the procedure, but also in terms of how to incorporate endoscopic sleeve gastroplasty and revision procedures and the intragastric balloon into clinical practice. Last but not least on this part of it on growth driver is, of course, reimbursement. With the recent announcements and the FDA clearance, we were able to continue to drive critical activities related to reimbursement. We are in the process of exploring new coding and new approaches for Medicare in how people undergo payment in the facility setting. We are in advanced discussions with the societies, both GI and surgical societies, around CPT codes and a new application there. We're developing a new patient access function to really support case-by-case prior authorizations. We're putting together the health economic materials and the value proposition and clinical evidence to really engage payers on reimbursement discussions and coverage discussions. Our second big growth driver has to do with our commercial team, which we continue to grow and develop. We mentioned previously our target at the end of the year to be at about 40 frontline sales reps by the end of the year. That is inclusive of both our market development managers, who are our sales reps who carry all 3 product lines, as well as the new regional endobariatric manager role, which focused on helping to grow and develop the endobariatric accounts. In addition, we're enhancing sales training, our sales analytics, growing our marketing capabilities, building out our physician medical education and training capabilities, all to build a stronger commercial organization. Importantly, we still have a relatively new team, right? About 1/2 of our team in the sales organization in the US still have less than one year experience at Apollo. A lot of credit to Kirk Ellis, our VP of sales here in the US, and his leadership team for delivering 25%+ growth over the past year, while essentially overhauling the entire commercial team. That's not an easy task, and they've been able to balance it well. We have been able to hire some excellent people on our team. Word has gotten out that good things are happening at Apollo, and people are actually coming to us, and we've become a net importer of very good talent. You see some of the examples of companies we've hired from places like Stryker and Medtronic and Boston Scientific within the last year. Okay, our next growth driver, we're talking about new product development, and I love talking about new product development. As I mentioned, we really have been adding into our resources on the R&D team, and Apollo's had an outstanding R&D team, including the folks that developed X-Tack originally. Our first new product coming out of this renewed focus on R&D is called OverStitch NXT. NXT is a new product, a new version of OverStitch. It's focused on single channels, Single-Channel scopes, but it actually offers capabilities that don't exist on either of our existing OverStitch products. It has increased retroflexion, it's got stronger catheters, it's got new tools that allow physicians to have more control over how they engage with tissue and do their suturing. It's much easier to use and install than the existing SX product, and much faster to use as well. The feedback that we've received from our clinicians who've gone through usability testing, as well as some of the allied health professionals who often are involved in setting up the device has been excellent. We are in the final stages now with the R&D process. We're going through the final product development testing, the final process validations, the things you do as you're getting ready towards a launch. We're targeting, if all that goes to plan, to be in a position to launch no later than the middle of next year. Importantly, NXT has the potential to create multiple opportunities for expanded access to suturing. Recall that, Single-Channel scopes are by far the most commonly used scopes on the market. The NXT product has big opportunities now to help us expand the adoption of OverStitch in both existing and new accounts. In our existing OverStitch SX accounts, it is a fundamentally better product, and we expect people to make that shift. In our existing accounts that primarily use Dual-Channel, the Dual-Channel OverStitch, many of them don't have enough Dual-Channel scopes, or they may not have the Dual-Channel scopes in all of their hospital settings, for example, satellite hospitals. They'll have reasons to want NXT as well. New accounts, it'll make a lot of sense to just start straight up with NXT. We have a lot of previous customers who tried OverStitch SX and had some struggles with the prior product. That's an obvious group to also tackle as well. More to follow on NXT as we get closer to the actual launch, but we're very excited by the progress we're making there in terms of bringing it to market and the role it can play in growth, starting in essentially the second 1/2 of next year. The fourth key driver here is around OUS opportunities. First I wanted to provide an update on the MDR process. The medical device regulations in Europe, those of you who follow the industry, I'm sure have heard about MDR. The transition for a lot of companies has been quite challenging, and so I'm very pleased to report that for Apollo, we are on track and anticipate having new EU MDR certifications for all of our legacy products completed by the end of this 1/4. It's a big accomplishment and a lot of credit to David Hooper, our VP of Regulatory, and his team for the success in navigating that. In addition, we actually have, excuse me, a positive outcome. In fact, I think maybe one of the only medical device companies that does, has had a positive outcome as a result of the MDR process, and that is some new labeling for OverStitch. These are all still being finalized, but we do expect it to look very similar to what you see on the page of new indications for defect closure, stent fixation, and endobariatric procedures. That we expect to be a big help for us in terms of being more specific in our marketing around those 3 indications and potentially helping in areas like reimbursement in places like the UK and France and Germany. Once we are complete with the legacy products, then we will turn our attention to the review process with the reviewers on X-Tack. We have made that submission, but clearly, just the way the process works, we want to get through the existing products first, and then we'll move to X-Tack, which we hope to complete during the first 1/2 of next year. In addition, outside the U.S., we've got some very substantial growth opportunities. As I mentioned, X-Tack, we are now cleared in nine markets outside the U.S., mostly smaller markets, but most recently, earlier this year in Australia, and we're ahead of plan in our execution there and adoption, and very recently in Brazil. And we've gotten some big orders out of Brazil and very good initial feedback, which continues to reinforce for us the view that X-Tack can have both very important clinical and economic value in markets outside the U.S. As I just mentioned, we're targeting a 2023 launch of X-Tack in the CE mark countries in Europe and other countries that follow CE mark. Some other opportunities, Canada. Ironically, given that more than 40% of our business is outside the U.S., we have a small presence in Canada. We're working to change that starting with new clearances for OverStitch and X-Tack that we're looking for in the first 1/2 of next year. Japan is another really exciting opportunity. We have already announced previously the clearance in Japan earlier this year in 2022. Mike Gutteridge, our VP of International Sales and Marketing, was just in Japan over the last 2 weeks and came back incredibly excited about the opportunities for both OverStitch and X-Tack as we continue to develop that market. Then China and Taiwan, we already have an initial clearance in China in Hainan Province. They've got a medical free trade port, which essentially gives you a foothold into China to start collecting data and collecting experience in the Chinese market. We've already completed cases, including our first ESGs there. We also have an emerging presence in Taiwan with some excellent clinicians and investigators who are already publishing data with 21% total body weight loss with ESGs in an Asian population. The combination of those 2 things, additional data and a foothold into mainland China, we think is gonna be very important and can help clear the way for clearances over the coming years. In summary, I'm on page 31, we've got a really exciting cadence of new catalysts over the next, call it year and a 1/2, as shown on this page, and look forward to continue to drive each of these forward. One area to highlight that I haven't talked about yet is about the ESG and Revise systems. We are on track to complete a limited launch here in the U.S. of those here this 1/4. That involves basically finalizing the manufacturing and doing a targeted launch in some select accounts. Then we'll be in a position to expand that to a full launch in the first 1/2 of next year. You see other elements of the cadence throughout. Finally, just to summarize, we're very pleased with the results of Q3, and we have increased our guidance to $75 million-$76 million, which imply operational growth of nearly 25%. Furthermore, all of the growth opportunities that I've talked about on the call gives us further confidence in reiterating what we communicated previously. A belief that we can be a consistent 20%+ grower in the years ahead, especially as we move into this accelerate phase of our strategy. With that, John, let's open up the call to questions. Thank you. Ladies and gentlemen, the floor is open for questions. If you have any questions or comments, please indicate so by pressing *1 on your touchtone phone. Pressing *2 will remove you from the queue should your question be answered. We ask that all participants with questions limit themselves to one question and one Follow-UP only. Lastly, while posing your question, please pick up your handset or if listening on speakerphone to provide optimum sound quality. Please hold while we poll for questions. The first question is coming from Matthew Blackman with Stifel. Matthew, your line is live. Good afternoon, everybody. Thank you for taking my questions. I've got one question and one Follow-UP. Let me just start. I'm sure you guys are anxious to guide for 2023, but just looking at how 2022 has played out so far, the implied fourth 1/4, is there any reason why you couldn't or shouldn't hit that midterm 20%+ growth, excluding currency next year? As I think about all the incremental drivers coming on board like ESG, continued X-Tack traction, perhaps the CPT code for IGB. Just any thoughts on how the business is shaping up as you head into 2023, and then one quick Follow-Up. Yeah. No, Matthew, I appreciate the question. We're not prepared to give formal guidance for the year, clearly. You know, in answer to your question, I think we feel good about the prospects as we laid out, right? You know, we've got good momentum across the business, especially on the ESS side of the business. The growth drivers, many of them are already kind of initiating, and then some will kick in, say, in the second 1/2 of the year, for example, with the NXT launch. We do feel good about that. The overall guidance, you know, having operationally in the range of 25% this year, we are excited about the prospects for the year ahead. Now there's some general macroeconomic factors I think we're all paying attention to, and we're not the only ones, but overall, feel good about the prospects ahead. I appreciate that. Just on ESG, just curious if you have any thoughts on sizing the cash pay opportunity and what it could be for ESG. I know it's challenging, but we've talked to docs who say something like 10% of their patients might be candidates to pay out of pocket, which I think equates to something like a $60-$70 million opportunity. Just curious how you guys are thinking about it, if you put any thought into how big the cash pay opportunity could be. Thanks. Appreciate it. Yeah. No, Matthew, we have done some more work on that recently, and it's really interesting, right? Because you've got some corollaries in other markets that actually turn out to be very big and significant opportunities, right? The obvious one is aesthetics. You know, the various aesthetic markets are well over $700 million for tummy tuck procedures and $1.3 billion for breast augmentation procedures. Another corollary is in men's health in urology. Jeannette Banks actually alerted us to this one 'cause she previously ran that business at Boston Scientific. A lot of that is cash pay, and it's a multi-hundred million dollar business. We've been doing some work in terms of the modeling of both the cash pay and the reimbursed side, and think with pretty modest assumptions on overall utilization that in total, that you know the business can be across both cash pay and reimbursed in the $450 million range within a call it 8-year, 8-10 year timeframe from now. With the cash pay part of it being maybe not fully 1/2, but 40%-45% of that. We think there's real opportunity there, and that's just also extrapolating on what we're already seeing in some of our existing customers. Great. Really appreciate it. Thank you so much. Congrats on a great 1/4. Thanks, Mattew. Okay. Up next, we have Matt Hewitt with Craig-Hallum Capital Group. Matt, your line is live. Good afternoon. Thank you for the detailed update, very appreciated. I guess first question, this past week the 2 key societies, ASMBS and IFSO, put out some new guidelines, and they for the first time in 30 years lowered the threshold for who qualifies or who should be recommended for bariatric surgeries. I'm just curious, and I realize it just hit, but what does that mean for your business? How does that expand the market opportunity for you, even on the cash pay side? It just my gut tells me that it's a pretty significant jump when you go from 35 or 40 BMI down to 30 BMI, and in some cases, even lower than that. Yeah. Matt, no, thanks for the question. You're right. The surgical society has been working on this for a while in terms of updating what have been very dated guidelines. It's based off of a lot of data that when you lose weight, substantial amounts of weight, there are significant advantages and benefits in comorbidities in areas like diabetes and hypertension and, you know, and metabolic syndrome, for example, as we saw in MERIT, right? We're pleased that they've updated the guidelines. Unclear how insurance companies may follow as it relates to starting with the surgical procedures that are covered now. At a minimum, it's further validation that Procedure-B ased approach for people with a BMI over 30 and then inclusive in some populations, even going down to the high 20s, because often obesity presents differently, especially in Asian populations, that they really should consider procedures and the health benefits there. You're right, that is a significant growth. It is a bell curve, right? It is a big growth in the number of patients who should be considered for procedures. Got it. Then maybe a Follow-UP. On one of the Slides, and I don't recall which one it was, and I apologize, but you've got a plan of training 50 physicians here, obviously, back 1/2 of this year, another 50, I think it was in the first 1/2 of next year, another 50 in the second 1/2 of next year. If I read the Slide correctly, what would prompt you to accelerate that training? Or are you just trying to be very methodical in how you're approaching ramping up your surgeon and physician practices with OverStitch? Thank you. Yeah. Matt, we communicated previously, and I think this is built off of a lot of experience in all of our prior lives, that at this stage, it's so much more about quality over quantity of new users, right? We absolutely want high quality training, and you saw the types of faculty members that we have. The right people coming to training, who are absolutely committed to doing these procedures the right way and put the right programs in place. Then, the right Follow-UP. That means proctoring cases, peer-to-peer coaching, those kinds of things. Our initial approach here is very targeted and focused in terms of delivering that. As we get more experience, especially with these first 2 courses, this 1/4, the numbers I showed or what we already have planned in are kind of minimums, I would say. We'll ramp it up based off of knowing we've got the right kind of recipe in place to scale effectively and to protect patient outcomes. Got it. All right. Thank you very much. Okay. Up next, we have Frank Takkinen with Lake Street Capital. Your line is live. Hey, thanks for taking my questions, and congrats on the results. Wanted to start with one on X-Tack. Appreciate the additional color. Was hoping you could bring us into account penetration a little bit. More specifically asking, how penetrated is X-Tack into the overarching OverStitch installed base? And then when you're thinking about penetration into the overlapping accounts, is there a synergistic benefit between the 2, if you have a rep selling multiple products into the same facility? Yeah. Frank, it depends on the account on the synergistic side. For example, you know, in our more comprehensive accounts that do a lot of defect closure work as well as maybe some endobariatric as well, there absolutely is a synergy, right? We started initially, as I think you know, with X-Tack, with people we know quite well. Those tend to be people who are using OverStitch, especially in the upper GI. In our early days with X-Tack, we had a higher proportion of X-Tack in the upper GI than I think honestly we had anticipated initially. As we've spent more time with the product and in those accounts and broadened out to a bigger group of people, even within the accounts, we're starting to see and have been a pretty steady trend of more of the procedures be in the lower GI, and the majority are now in the lower GI, which is what we would anticipate based on how the product was originally designed and intended to be used. As we think about penetration, there's both penetration into the number of the OverStitch accounts. I don't have that number in front of me, but Jeffrey maybe will provide it. But then also the number of users per account. As we continue to drive depth of utilization of X-Tack, part of it is also getting more people within those accounts, 'cause people, I mean, many of the institutions you see, you know, maybe one or 2 people who will use OverStitch, but more that will use X-Tack. Yeah, Frank, I think you know, without giving information that's Non-public, and we typically keep some of this close to the vest, but generally what we've talked about is our OverStitch account base is you know, somewhere in the 400-450 range in terms of quarterly ordering accounts. X-Tack is not there yet, but continuing to grow. Year-Over-Year, it's grown pretty substantially, even sequentially. So there is a fair amount of overlap, but just we've also been able to bring on a number of new X-Tack accounts as well. So it's a mix of existing accounts and new accounts, and that's what's really driving the X-Tack growth. Got it. Okay. Maybe on my Follow-Up, just sales rep productivity. I heard your comment around only about 1/2 the force being there for less than 12 months. Maybe talk to timeline to full productivity and what that can look like from a revenue basis per rep. It's a good mix of products, but they do take a while to come up to speed. We do think that somewhere in that 6-12 months is when people really start to hit their stride, which is not atypical in the industry. Our target on average, as we do planning, is on average territory sizes in the range of $1.5 million per rep. That's kind of. Those are rules of thumb that we operate against and are trying to build towards that as the team, you know, develops in place and as we put the right things around them from a, as I mentioned, marketing and training and data analytics standpoint. We already have plenty of reps who are at that level, but have that be consistent across the whole group, that's kind of what we're shooting for. Got it. That's helpful. I'll stop there. Thanks for taking my questions. Thanks, Frank. Once again, if there are any remaining questions or comments, please indicate so by pressing star one on your touch tone phone. Up next, we have Joshua Jennings with Cowen. Josh, your line is live. Hi, good afternoon. Congratulations on the strong print, and thanks for taking the questions. I wanted to just ask a Follow-Up on the training playbook. I mean, it sounds like the physicians that are funneling in for these bariatric training camps are experienced with OverStitch. I think, Jeffrey, you just talked about 450 centers with OverStitch experience. But as we think about, I guess, building the funnel of OverStitch-experienced physicians before they move forward with the ESG training, is that the right way to think about it? Maybe you can talk about that pre-funnel, if that is how you guys are approaching this and then how that builds out. Yeah. It's a good way to think about it, Josh. Especially in these initial courses this year, we really are focusing on primarily, not exclusively, people who have already been trained on OverStitch. But we are getting a lot of Brand-New interest as well, and that's from both GIs and surgeons. Really interesting on the surgeon side, right? There, I think, has been a bit of a sea change in the last 2-3 months with the announcements, right? The validation that comes with FDA plus Lancet is real and starting to hear and see some of these models, like the one I mentioned with Dr. VanderWeele, is prompting some, you know, high volume and/or very influential surgeons to really take note and now want to get involved. We absolutely are kind of developing the list of kind of the new wave beyond the ones I mentioned. I think increasingly we're going through now the process to get them through initial training on OverStitch so that they can, say, participate in the course in February or the one after that. We absolutely will view this as a nice pipeline that will continue and continue to grow the base. Well, just in terms of that mix, Chas, you just spoke to between gastroenterologists and bariatric surgeons. Is that the mix is evolving, but where were you, I guess, prior to the data? I mean, we are assuming something along the lines of 80/20 gastro to bariatric surgeon. Is that moving closer to 2-1/3s, one-1/3, or anything you can share there from that mix perspective in terms of subspecialists that are wanting to get trained on ESG? Yeah, no, I mean, historically in the US, because it does vary a little bit by markets outside the US, but historically in the US, we really have been predominantly GI-based users of OverStitch. They use it across the whole range of applications for OverStitch, and then inclusive on the weight loss side, they've been the ones most interested in adopting it for weight loss procedures. I mean, it may even be a little historically even higher than the 80/20 you mentioned. But like I said, now we are seeing an interest on the surgeon side. I do think that as that progresses, it'll be an evolution over time. It's not gonna be a sea change, but an evolution where more surgeons get involved and view it. The important, I think, piece, as I mentioned in my comments, is the surgeons who understand and view this as complementary to what they do and a way to treat more patients. There are many who are now kinda figuring that part out and are excited about now incorporating it into their practice. Excellent. Just one quick Follow-Up for Jeffrey, or you, Chas. Just on the price increases, any way to think about that or to quantify that in terms of the impact to. Yes. Yeah. Jeffrey, I think again we made a decision earlier in the year to roll out some price increases. We've also just recently done it. In terms of growth, as you start to think about 1/3 1/4 growth, most of the growth came from volume, you know, a moderate percentage, call it, you know, very low single digit percentage was price. I think that mix will increase 'cause we'll start to see the impact of the recent price increases over the next couple quarters. You know, think about it in terms of, you know, somewhere in the, call it mid-single digit range price increase across the board. Okay. Does NXT or OverStitch NXT give you another opportunity to take price up next year? Thanks. Sorry for the extra questions. Yeah. We're excited about NXT. We haven't finalized the pricing strategy for it. Yeah, it is a new product with new features and benefits, and so we are working through that. We would anticipate the opportunity to have some additional price as well as we launch and finalize the systems. We look at an opportunity to have an increase in price there as well. We'll provide more information on both of those as we progress here in the next year. Thank you. Okay. Up next, we have Adam Maeder with Piper Sandler. Your line is live. Hi, this is Simran on for Adam Maeder. Thank you guys for taking the questions, and congrats on the 1/4. Maybe if I can start off with OverStitch NXT. Can you talk a bit more about how this will fit into the broader ESS portfolio? I mean, is this expected to kind of be the workhorse OverStitch device and, you know, replace the current offerings? Then, I know you spoke about pricing a little bit in the previous question, but, you know, is this going to be another area that'll help to kind of, you know, improve margins going forward because of your ability to take price here? Let me start with the positioning around NXT. NXT is it will be used on single channel scopes, and we certainly see it and envision it becoming the workhorse for any existing single channel scope customers. I think that's sort of the bare minimum. Over time, absolutely, if it delivers the way we expect it to based off of the usability testing, we see it as an opportunity to, especially with any new users, and then as I mentioned, with a number of our existing dual channel users, become a big part of what they do. Replace versus become a complement, for example, in different settings of care, still to be determined in terms of how that plays out. Over time, absolutely replacing SX and probably becoming a pretty significant part of our mix overall. That'll, by the way, vary internationally by market in some cases, where just regulatory processes take longer and whatnot. We may have a period where we've got all 3 products on the market internationally for a period of time. Then, as I mentioned, we're still working through the pricing strategy and what the margin implications will be, around NXT, but we're excited about the additional features and benefits and how we'll roll that out, and we'll provide more update at that point. Okay, perfect. If I could ask one more on just OpEx spend. How should we think about that going forward? I know, you know, you're driving investments in a lot of key areas, so, maybe just speak from a higher level in 2023, how we should be thinking about OpEx spends and, you know, potentially driving leverage down, the bottom line. Yes, Simran, it's a great question. Just to give you a sense of you know, the OpEx profile, right? We did see some leverage sequentially in the 1/3 1/4, but realized that, you know, for every $100,000 in spend, it's 50 basis points of operating leverage. The ability to modulate spend will definitely have an impact, or just the timing of spend will have an impact. I think more broadly speaking, we will continue to invest. We're gonna have to build out the sales channel, build out marketing programs, you know, build out reimbursement, and we'll continue to make investment in R&D. We will start to see leverage. I think the way to think about it is that, you know, our expectation is we'll see our revenue growth in 2023 will outpace our OpEx growth. We will start to see some leverage. It paints a nice picture for us toward that cash flow breakeven model. Okay, perfect. If I could squeeze one last one. OverStitch Japan, what still needs to be squared up prior to launch, and how do we think about potential impact in 2023? Thank you, guys. We already have OverStitch cleared, and it already gets used in some cases in Japan with very good feedback from clinicians. Those are ones that are able to kinda fit it into their hospitals. The next stage is still working through reimbursement processes, and we are in the process of working through that. We anticipate kind of a build of, you know, some additional modest impact here in the near term, but then over time, as we work through those and over the next few years, potentially quite substantial. I'm not really ready to put a number on it for you, except to say that Japan is a very important market in the interventional therapeutic GI world. Some of the real thought leaders in the world are based in Japan. As I mentioned from our visit from Mike, our VP in the area, the interest level and excitement in Japan around both OverStitch NXT is very high. We think it can be meaningful, but it'll be sort of progressing here over the next, you know, 1-3 years. Okay. I'd like to turn the floor back to management for any closing remarks. Well, listen, thank you all for joining us today. In summary, we are very pleased with the performance in the 1/4. We look forward to delivering on the multiple growth opportunities that is held, and we recommit to becoming a consistent 20%+ growing company going forward. We look forward to that, and thank you all for your time today, and good afternoon. Thank you, ladies and gentlemen. This does conclude today's conference call. You may disconnect your phone lines.