<?xml version="1.0" encoding="UTF-8"?>

<!--XBRL Document Created with the Workiva Platform-->
<!--Copyright 2024 Workiva-->
<!--r:93a65b4d-9b37-4cb5-a6f1-f7a2cd34737f,g:13a2a5be-c091-49df-bd13-09c5904a63e9-->
<link:linkbase xmlns:link="http://www.xbrl.org/2003/linkbase" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xbrldt="http://xbrl.org/2005/xbrldt" xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
  <link:arcroleRef arcroleURI="http://xbrl.org/int/dim/arcrole/all" xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#all"/>
  <link:arcroleRef arcroleURI="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#hypercube-dimension"/>
  <link:arcroleRef arcroleURI="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#dimension-default"/>
  <link:arcroleRef arcroleURI="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#dimension-domain"/>
  <link:arcroleRef arcroleURI="http://xbrl.org/int/dim/arcrole/domain-member" xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#domain-member"/>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/ConsolidatedStatementsOfIncome" xlink:type="simple" xlink:href="isrg-20231231.xsd#ConsolidatedStatementsOfIncome"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/ConsolidatedStatementsOfIncome" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StatementLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StatementTable_4fd2d3bd-29f7-442b-be55-16d25f39afbe" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StatementTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_StatementTable_4fd2d3bd-29f7-442b-be55-16d25f39afbe" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_ProductOrServiceAxis_8aa34c5e-5a10-48ab-bc3b-f802589cb70f" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_ProductOrServiceAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_StatementTable_4fd2d3bd-29f7-442b-be55-16d25f39afbe" xlink:to="loc_srt_ProductOrServiceAxis_8aa34c5e-5a10-48ab-bc3b-f802589cb70f" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_ProductsAndServicesDomain_8aa34c5e-5a10-48ab-bc3b-f802589cb70f_default" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_ProductsAndServicesDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_srt_ProductOrServiceAxis_8aa34c5e-5a10-48ab-bc3b-f802589cb70f" xlink:to="loc_srt_ProductsAndServicesDomain_8aa34c5e-5a10-48ab-bc3b-f802589cb70f_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_ProductsAndServicesDomain_9820355b-e643-4257-bf90-a1ab75e2a6e1" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_ProductsAndServicesDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_srt_ProductOrServiceAxis_8aa34c5e-5a10-48ab-bc3b-f802589cb70f" xlink:to="loc_srt_ProductsAndServicesDomain_9820355b-e643-4257-bf90-a1ab75e2a6e1" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ProductMember_80fc86fe-1218-403d-bbe5-434ef48948d4" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ProductMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_ProductsAndServicesDomain_9820355b-e643-4257-bf90-a1ab75e2a6e1" xlink:to="loc_us-gaap_ProductMember_80fc86fe-1218-403d-bbe5-434ef48948d4" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ServiceMember_feb82a80-25d3-49f6-8b10-2fe8e6e0dcc5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ServiceMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_ProductsAndServicesDomain_9820355b-e643-4257-bf90-a1ab75e2a6e1" xlink:to="loc_us-gaap_ServiceMember_feb82a80-25d3-49f6-8b10-2fe8e6e0dcc5" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RelatedPartyTransactionsByRelatedPartyAxis_68ad30c1-655a-44bb-92de-1cb3f3b4d6e3" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RelatedPartyTransactionsByRelatedPartyAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_StatementTable_4fd2d3bd-29f7-442b-be55-16d25f39afbe" xlink:to="loc_us-gaap_RelatedPartyTransactionsByRelatedPartyAxis_68ad30c1-655a-44bb-92de-1cb3f3b4d6e3" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RelatedPartyDomain_68ad30c1-655a-44bb-92de-1cb3f3b4d6e3_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RelatedPartyDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_RelatedPartyTransactionsByRelatedPartyAxis_68ad30c1-655a-44bb-92de-1cb3f3b4d6e3" xlink:to="loc_us-gaap_RelatedPartyDomain_68ad30c1-655a-44bb-92de-1cb3f3b4d6e3_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RelatedPartyDomain_9c94e149-66d4-406f-a88f-989d0a654ffa" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RelatedPartyDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_RelatedPartyTransactionsByRelatedPartyAxis_68ad30c1-655a-44bb-92de-1cb3f3b4d6e3" xlink:to="loc_us-gaap_RelatedPartyDomain_9c94e149-66d4-406f-a88f-989d0a654ffa" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CorporateJointVentureMember_50b2c355-2db9-446f-8ad9-1acf27b645c1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CorporateJointVentureMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RelatedPartyDomain_9c94e149-66d4-406f-a88f-989d0a654ffa" xlink:to="loc_us-gaap_CorporateJointVentureMember_50b2c355-2db9-446f-8ad9-1acf27b645c1" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenuesAbstract_d214a6ee-0101-40d6-8464-3e86ff050844" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenuesAbstract"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_RevenuesAbstract_d214a6ee-0101-40d6-8464-3e86ff050844" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax_c273a763-f58f-457b-b9b6-ad39bbd835fc" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RevenuesAbstract_d214a6ee-0101-40d6-8464-3e86ff050844" xlink:to="loc_us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax_c273a763-f58f-457b-b9b6-ad39bbd835fc" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CostOfRevenueAbstract_c154eb6e-36e3-4410-8983-b5b24f06e0a9" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CostOfRevenueAbstract"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_CostOfRevenueAbstract_c154eb6e-36e3-4410-8983-b5b24f06e0a9" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CostOfGoodsAndServicesSold_348e4213-4b5e-43ca-b25b-898fb1521db9" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CostOfGoodsAndServicesSold"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_CostOfRevenueAbstract_c154eb6e-36e3-4410-8983-b5b24f06e0a9" xlink:to="loc_us-gaap_CostOfGoodsAndServicesSold_348e4213-4b5e-43ca-b25b-898fb1521db9" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GrossProfit_8d33d6e4-be25-4d62-b541-cc6307c3d905" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GrossProfit"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_GrossProfit_8d33d6e4-be25-4d62-b541-cc6307c3d905" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OperatingExpensesAbstract_c3e8c96e-96c7-4bc7-aca1-268fe3e060b9" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OperatingExpensesAbstract"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_OperatingExpensesAbstract_c3e8c96e-96c7-4bc7-aca1-268fe3e060b9" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SellingGeneralAndAdministrativeExpense_33d45d3f-cd2d-4f05-a1b4-297d54df1820" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SellingGeneralAndAdministrativeExpense"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_OperatingExpensesAbstract_c3e8c96e-96c7-4bc7-aca1-268fe3e060b9" xlink:to="loc_us-gaap_SellingGeneralAndAdministrativeExpense_33d45d3f-cd2d-4f05-a1b4-297d54df1820" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ResearchAndDevelopmentExpense_72645f1d-5405-4cd0-bb47-7d8ca34248ac" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ResearchAndDevelopmentExpense"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_OperatingExpensesAbstract_c3e8c96e-96c7-4bc7-aca1-268fe3e060b9" xlink:to="loc_us-gaap_ResearchAndDevelopmentExpense_72645f1d-5405-4cd0-bb47-7d8ca34248ac" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OperatingExpenses_001ce741-6416-451f-a902-4baee03b5235" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OperatingExpenses"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_OperatingExpensesAbstract_c3e8c96e-96c7-4bc7-aca1-268fe3e060b9" xlink:to="loc_us-gaap_OperatingExpenses_001ce741-6416-451f-a902-4baee03b5235" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OperatingIncomeLoss_b86b22f6-0939-4697-9be2-1ea5a4062cb6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OperatingIncomeLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_OperatingIncomeLoss_b86b22f6-0939-4697-9be2-1ea5a4062cb6" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_NonoperatingIncomeExpense_684e06d2-e9bc-4678-9f27-706d4d5e880a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_NonoperatingIncomeExpense"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_NonoperatingIncomeExpense_684e06d2-e9bc-4678-9f27-706d4d5e880a" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest_c9885754-d168-4feb-a1f2-5692b34f7dcf" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest_c9885754-d168-4feb-a1f2-5692b34f7dcf" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeTaxExpenseBenefit_41f87f8e-3230-49cb-bc8e-4db5ade7d724" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeTaxExpenseBenefit"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_IncomeTaxExpenseBenefit_41f87f8e-3230-49cb-bc8e-4db5ade7d724" xlink:type="arc" order="7"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ProfitLoss_4da00abd-dd8a-47b6-bcad-bc05419de3ea" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ProfitLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_ProfitLoss_4da00abd-dd8a-47b6-bcad-bc05419de3ea" xlink:type="arc" order="8"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_278ac959-40df-4b99-9e04-70639645b462" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_278ac959-40df-4b99-9e04-70639645b462" xlink:type="arc" order="9"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_NetIncomeLoss_90e87966-e920-4e58-8c4d-2c15e88a8e83" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_NetIncomeLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_NetIncomeLoss_90e87966-e920-4e58-8c4d-2c15e88a8e83" xlink:type="arc" order="10"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EarningsPerShareAbstract_1a4df874-e612-42d3-a36e-603e3fed38b9" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EarningsPerShareAbstract"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_EarningsPerShareAbstract_1a4df874-e612-42d3-a36e-603e3fed38b9" xlink:type="arc" order="11"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EarningsPerShareBasic_37639c5d-94f7-4b7c-a5a9-b864a4fc5bb9" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EarningsPerShareBasic"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EarningsPerShareAbstract_1a4df874-e612-42d3-a36e-603e3fed38b9" xlink:to="loc_us-gaap_EarningsPerShareBasic_37639c5d-94f7-4b7c-a5a9-b864a4fc5bb9" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EarningsPerShareDiluted_336f7c01-21a2-4478-8192-603a6aa28770" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EarningsPerShareDiluted"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EarningsPerShareAbstract_1a4df874-e612-42d3-a36e-603e3fed38b9" xlink:to="loc_us-gaap_EarningsPerShareDiluted_336f7c01-21a2-4478-8192-603a6aa28770" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract_d0dc2d78-f063-4755-9bdf-be965ad66459" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_ac507188-71a1-45bc-8b12-9ed4dbdb5883" xlink:to="loc_us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract_d0dc2d78-f063-4755-9bdf-be965ad66459" xlink:type="arc" order="12"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_132d18e5-060d-4274-9ea3-30f506b3fe3b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract_d0dc2d78-f063-4755-9bdf-be965ad66459" xlink:to="loc_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_132d18e5-060d-4274-9ea3-30f506b3fe3b" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_37d49900-55df-43f6-afaf-a760c6f99a80" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract_d0dc2d78-f063-4755-9bdf-be965ad66459" xlink:to="loc_us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_37d49900-55df-43f6-afaf-a760c6f99a80" xlink:type="arc" order="2"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/ConsolidatedStatementsOfStockholdersEquity" xlink:type="simple" xlink:href="isrg-20231231.xsd#ConsolidatedStatementsOfStockholdersEquity"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/ConsolidatedStatementsOfStockholdersEquity" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StatementLineItems_81c984ea-8ea3-45a0-aef0-511cc7cad15d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StatementLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StatementTable_2f3d3703-ef0e-4cd2-b27c-0463addf75c8" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StatementTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_StatementLineItems_81c984ea-8ea3-45a0-aef0-511cc7cad15d" xlink:to="loc_us-gaap_StatementTable_2f3d3703-ef0e-4cd2-b27c-0463addf75c8" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StatementEquityComponentsAxis_afcbaa88-7e67-4168-bd4e-e98327561286" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StatementEquityComponentsAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_StatementTable_2f3d3703-ef0e-4cd2-b27c-0463addf75c8" xlink:to="loc_us-gaap_StatementEquityComponentsAxis_afcbaa88-7e67-4168-bd4e-e98327561286" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityComponentDomain_afcbaa88-7e67-4168-bd4e-e98327561286_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityComponentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_StatementEquityComponentsAxis_afcbaa88-7e67-4168-bd4e-e98327561286" xlink:to="loc_us-gaap_EquityComponentDomain_afcbaa88-7e67-4168-bd4e-e98327561286_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityComponentDomain_3b1d3144-cada-4aa8-9a07-a0633912910d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityComponentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_StatementEquityComponentsAxis_afcbaa88-7e67-4168-bd4e-e98327561286" xlink:to="loc_us-gaap_EquityComponentDomain_3b1d3144-cada-4aa8-9a07-a0633912910d" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CommonStockMember_8a08bea3-8f46-42d2-bd0d-9f2d384121dd" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CommonStockMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_3b1d3144-cada-4aa8-9a07-a0633912910d" xlink:to="loc_us-gaap_CommonStockMember_8a08bea3-8f46-42d2-bd0d-9f2d384121dd" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AdditionalPaidInCapitalMember_3845deaa-7b24-43c2-90a5-69b17ad9ab80" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AdditionalPaidInCapitalMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_3b1d3144-cada-4aa8-9a07-a0633912910d" xlink:to="loc_us-gaap_AdditionalPaidInCapitalMember_3845deaa-7b24-43c2-90a5-69b17ad9ab80" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RetainedEarningsMember_7e923e26-ac16-402f-b11b-3887e9a1fb34" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RetainedEarningsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_3b1d3144-cada-4aa8-9a07-a0633912910d" xlink:to="loc_us-gaap_RetainedEarningsMember_7e923e26-ac16-402f-b11b-3887e9a1fb34" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AccumulatedOtherComprehensiveIncomeMember_77457deb-62b4-4799-bc94-ba9764336399" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AccumulatedOtherComprehensiveIncomeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_3b1d3144-cada-4aa8-9a07-a0633912910d" xlink:to="loc_us-gaap_AccumulatedOtherComprehensiveIncomeMember_77457deb-62b4-4799-bc94-ba9764336399" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ParentMember_691ec128-38fd-45c0-a547-359125824460" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ParentMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_3b1d3144-cada-4aa8-9a07-a0633912910d" xlink:to="loc_us-gaap_ParentMember_691ec128-38fd-45c0-a547-359125824460" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_NoncontrollingInterestMember_bef23f5d-8a1a-48a3-aee5-52cfe4da7057" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_NoncontrollingInterestMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_3b1d3144-cada-4aa8-9a07-a0633912910d" xlink:to="loc_us-gaap_NoncontrollingInterestMember_bef23f5d-8a1a-48a3-aee5-52cfe4da7057" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncreaseDecreaseInStockholdersEquityRollForward"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_StatementLineItems_81c984ea-8ea3-45a0-aef0-511cc7cad15d" xlink:to="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CommonStockSharesOutstanding_6788dce3-ddec-456f-a4fc-84103721b602" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CommonStockSharesOutstanding"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_CommonStockSharesOutstanding_6788dce3-ddec-456f-a4fc-84103721b602" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_389ddc6d-d201-4b09-840b-696bd2b03e75" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_389ddc6d-d201-4b09-840b-696bd2b03e75" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation_7815381c-37e2-45ab-bd33-c1c5614028fc" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation_7815381c-37e2-45ab-bd33-c1c5614028fc" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation_3e751ff9-6627-4708-92fe-4062b5116910" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation_3e751ff9-6627-4708-92fe-4062b5116910" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation_1d607f44-b26d-4791-b918-eef3afc1c0d6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation_1d607f44-b26d-4791-b918-eef3afc1c0d6" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation_6b2fdd23-b3fb-4a88-a4be-43fe6dabd9ff" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation_6b2fdd23-b3fb-4a88-a4be-43fe6dabd9ff" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue_b94c1513-97f1-4224-a815-b52b6ee628bd" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue_b94c1513-97f1-4224-a815-b52b6ee628bd" xlink:type="arc" order="7"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodShares_5b7208a8-a2ec-4252-b45e-4bd669d6fdb7" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockRepurchasedAndRetiredDuringPeriodShares"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodShares_5b7208a8-a2ec-4252-b45e-4bd669d6fdb7" xlink:type="arc" order="8"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodValue_56501748-babb-4781-b29d-4a31a1b781fc" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockRepurchasedAndRetiredDuringPeriodValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodValue_56501748-babb-4781-b29d-4a31a1b781fc" xlink:type="arc" order="9"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_NetIncomeLoss_f3626884-e812-42d4-84ee-0852c685e967" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_NetIncomeLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_NetIncomeLoss_f3626884-e812-42d4-84ee-0852c685e967" xlink:type="arc" order="10"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OtherComprehensiveIncomeLossNetOfTax_5d877a8b-2e06-4743-900e-145440c27b6c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OtherComprehensiveIncomeLossNetOfTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_OtherComprehensiveIncomeLossNetOfTax_5d877a8b-2e06-4743-900e-145440c27b6c" xlink:type="arc" order="11"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_49642fc1-9ff5-44cc-a151-fa93ce06c719" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncreaseDecreaseInStockholdersEquityRollForward_28a5b7e0-7161-455b-aedc-b5ff34242cae" xlink:to="loc_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_49642fc1-9ff5-44cc-a151-fa93ce06c719" xlink:type="arc" order="12"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CommonStockSharesOutstanding_e5f6c236-e240-418d-9bfa-30b722ef1911" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CommonStockSharesOutstanding"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_2589b326-08d6-4214-a605-816c11357b4c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/SummaryOfSignificantAccountingPoliciesAdditionalInformationDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#SummaryOfSignificantAccountingPoliciesAdditionalInformationDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/SummaryOfSignificantAccountingPoliciesAdditionalInformationDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:href="isrg-20231231.xsd#isrg_SummaryOfSignificantAccountingPoliciesLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_SummaryOfSignificantAccountingPoliciesTable_89f62c8e-1d58-4e51-9729-e10be4ec6b26" xlink:href="isrg-20231231.xsd#isrg_SummaryOfSignificantAccountingPoliciesTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_isrg_SummaryOfSignificantAccountingPoliciesTable_89f62c8e-1d58-4e51-9729-e10be4ec6b26" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ConcentrationRiskByBenchmarkAxis_435c0453-41e9-41f6-bd5e-f8e59b465d7e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesTable_89f62c8e-1d58-4e51-9729-e10be4ec6b26" xlink:to="loc_us-gaap_ConcentrationRiskByBenchmarkAxis_435c0453-41e9-41f6-bd5e-f8e59b465d7e" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ConcentrationRiskBenchmarkDomain_435c0453-41e9-41f6-bd5e-f8e59b465d7e_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ConcentrationRiskBenchmarkDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_ConcentrationRiskByBenchmarkAxis_435c0453-41e9-41f6-bd5e-f8e59b465d7e" xlink:to="loc_us-gaap_ConcentrationRiskBenchmarkDomain_435c0453-41e9-41f6-bd5e-f8e59b465d7e_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ConcentrationRiskBenchmarkDomain_a5123e21-9319-4d47-8e7b-8bd62304b711" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ConcentrationRiskBenchmarkDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_ConcentrationRiskByBenchmarkAxis_435c0453-41e9-41f6-bd5e-f8e59b465d7e" xlink:to="loc_us-gaap_ConcentrationRiskBenchmarkDomain_a5123e21-9319-4d47-8e7b-8bd62304b711" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AccountsReceivableMember_60e6b49b-9f60-44b4-9a9d-b2c5af28c159" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AccountsReceivableMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ConcentrationRiskBenchmarkDomain_a5123e21-9319-4d47-8e7b-8bd62304b711" xlink:to="loc_us-gaap_AccountsReceivableMember_60e6b49b-9f60-44b4-9a9d-b2c5af28c159" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_TotalRevenueMember_09932516-8422-43e0-b4eb-f551165f8ff8" xlink:href="isrg-20231231.xsd#isrg_TotalRevenueMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ConcentrationRiskBenchmarkDomain_a5123e21-9319-4d47-8e7b-8bd62304b711" xlink:to="loc_isrg_TotalRevenueMember_09932516-8422-43e0-b4eb-f551165f8ff8" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ConcentrationRiskByTypeAxis_b66aa875-ba8f-44b6-b14e-0a28c0a685c6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ConcentrationRiskByTypeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesTable_89f62c8e-1d58-4e51-9729-e10be4ec6b26" xlink:to="loc_us-gaap_ConcentrationRiskByTypeAxis_b66aa875-ba8f-44b6-b14e-0a28c0a685c6" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ConcentrationRiskTypeDomain_b66aa875-ba8f-44b6-b14e-0a28c0a685c6_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ConcentrationRiskTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_ConcentrationRiskByTypeAxis_b66aa875-ba8f-44b6-b14e-0a28c0a685c6" xlink:to="loc_us-gaap_ConcentrationRiskTypeDomain_b66aa875-ba8f-44b6-b14e-0a28c0a685c6_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ConcentrationRiskTypeDomain_2b296d37-3c33-4f25-9d23-5829efab54f2" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ConcentrationRiskTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_ConcentrationRiskByTypeAxis_b66aa875-ba8f-44b6-b14e-0a28c0a685c6" xlink:to="loc_us-gaap_ConcentrationRiskTypeDomain_2b296d37-3c33-4f25-9d23-5829efab54f2" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicConcentrationRiskMember_ce5bb56a-53e1-487c-989f-a2780726c97d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicConcentrationRiskMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ConcentrationRiskTypeDomain_2b296d37-3c33-4f25-9d23-5829efab54f2" xlink:to="loc_us-gaap_GeographicConcentrationRiskMember_ce5bb56a-53e1-487c-989f-a2780726c97d" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionAxis_dc313f43-4244-46f9-926e-ce4462abf0ad" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesTable_89f62c8e-1d58-4e51-9729-e10be4ec6b26" xlink:to="loc_us-gaap_GeographicDistributionAxis_dc313f43-4244-46f9-926e-ce4462abf0ad" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionDomain_dc313f43-4244-46f9-926e-ce4462abf0ad_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_GeographicDistributionAxis_dc313f43-4244-46f9-926e-ce4462abf0ad" xlink:to="loc_us-gaap_GeographicDistributionDomain_dc313f43-4244-46f9-926e-ce4462abf0ad_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionDomain_95f9a194-dea4-4a98-b28c-97a7083a5d62" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_GeographicDistributionAxis_dc313f43-4244-46f9-926e-ce4462abf0ad" xlink:to="loc_us-gaap_GeographicDistributionDomain_95f9a194-dea4-4a98-b28c-97a7083a5d62" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionDomesticMember_b921c513-717d-44ea-a85e-102197823ca6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionDomesticMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_GeographicDistributionDomain_95f9a194-dea4-4a98-b28c-97a7083a5d62" xlink:to="loc_us-gaap_GeographicDistributionDomesticMember_b921c513-717d-44ea-a85e-102197823ca6" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionForeignMember_64ef0ff8-3626-4ef7-8738-287887907654" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionForeignMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_GeographicDistributionDomain_95f9a194-dea4-4a98-b28c-97a7083a5d62" xlink:to="loc_us-gaap_GeographicDistributionForeignMember_64ef0ff8-3626-4ef7-8738-287887907654" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeAxis_fc7348fd-1b67-4526-b33f-325d38b70fdc" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesTable_89f62c8e-1d58-4e51-9729-e10be4ec6b26" xlink:to="loc_srt_RangeAxis_fc7348fd-1b67-4526-b33f-325d38b70fdc" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeMember_fc7348fd-1b67-4526-b33f-325d38b70fdc_default" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_srt_RangeAxis_fc7348fd-1b67-4526-b33f-325d38b70fdc" xlink:to="loc_srt_RangeMember_fc7348fd-1b67-4526-b33f-325d38b70fdc_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeMember_4d24dbc3-e6e0-4f36-836b-6c0bf68780c5" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_srt_RangeAxis_fc7348fd-1b67-4526-b33f-325d38b70fdc" xlink:to="loc_srt_RangeMember_4d24dbc3-e6e0-4f36-836b-6c0bf68780c5" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_MaximumMember_c1bb8157-21b0-44db-8832-e935146f47b4" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_MaximumMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_RangeMember_4d24dbc3-e6e0-4f36-836b-6c0bf68780c5" xlink:to="loc_srt_MaximumMember_c1bb8157-21b0-44db-8832-e935146f47b4" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_MinimumMember_65946c03-89f3-475f-a827-275b790ad989" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_MinimumMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_RangeMember_4d24dbc3-e6e0-4f36-836b-6c0bf68780c5" xlink:to="loc_srt_MinimumMember_65946c03-89f3-475f-a827-275b790ad989" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PropertyPlantAndEquipmentByTypeAxis_07885079-2b66-4e7a-8674-ea56253bf658" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesTable_89f62c8e-1d58-4e51-9729-e10be4ec6b26" xlink:to="loc_us-gaap_PropertyPlantAndEquipmentByTypeAxis_07885079-2b66-4e7a-8674-ea56253bf658" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_07885079-2b66-4e7a-8674-ea56253bf658_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentByTypeAxis_07885079-2b66-4e7a-8674-ea56253bf658" xlink:to="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_07885079-2b66-4e7a-8674-ea56253bf658_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_d3bb5bbc-6167-4b1f-929a-6857c3c6093a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentByTypeAxis_07885079-2b66-4e7a-8674-ea56253bf658" xlink:to="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_d3bb5bbc-6167-4b1f-929a-6857c3c6093a" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SoftwareAndSoftwareDevelopmentCostsMember_003bb0c3-ff32-4a70-ac29-0e3335afc280" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SoftwareAndSoftwareDevelopmentCostsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_d3bb5bbc-6167-4b1f-929a-6857c3c6093a" xlink:to="loc_us-gaap_SoftwareAndSoftwareDevelopmentCostsMember_003bb0c3-ff32-4a70-ac29-0e3335afc280" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockholdersEquityNoteStockSplitConversionRatio1_eb43190e-209e-49d6-b11e-b032c0500e10" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockholdersEquityNoteStockSplitConversionRatio1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_StockholdersEquityNoteStockSplitConversionRatio1_eb43190e-209e-49d6-b11e-b032c0500e10" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CommonStockParOrStatedValuePerShare_af04023e-d2f1-4339-8ecb-e1173274d63a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CommonStockParOrStatedValuePerShare"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_CommonStockParOrStatedValuePerShare_af04023e-d2f1-4339-8ecb-e1173274d63a" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ConcentrationRiskPercentage1_b5e00e5b-541c-4543-afae-455349440b15" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ConcentrationRiskPercentage1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_ConcentrationRiskPercentage1_b5e00e5b-541c-4543-afae-455349440b15" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RestrictedCash_86ad396c-447c-4d4b-abca-dcca1d62f91f" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RestrictedCash"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_RestrictedCash_86ad396c-447c-4d4b-abca-dcca1d62f91f" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_Depreciation_ebd08885-a3ed-41a8-8009-6dffc10d8d84" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_Depreciation"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_Depreciation_ebd08885-a3ed-41a8-8009-6dffc10d8d84" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PropertyPlantAndEquipmentUsefulLife_1d9dde79-5281-4ead-a2f5-c2c69119e387" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_PropertyPlantAndEquipmentUsefulLife_1d9dde79-5281-4ead-a2f5-c2c69119e387" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_HostingArrangementServiceContractImplementationCostExpenseAmortization_8375fa8f-068b-48ca-85d1-e234dd86117a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_HostingArrangementServiceContractImplementationCostExpenseAmortization"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_HostingArrangementServiceContractImplementationCostExpenseAmortization_8375fa8f-068b-48ca-85d1-e234dd86117a" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_NumberOfOperatingSegments_3580ec4d-6b38-45cc-9250-ecdf94ad0fe6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_NumberOfOperatingSegments"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_NumberOfOperatingSegments_3580ec4d-6b38-45cc-9250-ecdf94ad0fe6" xlink:type="arc" order="7"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FiniteLivedIntangibleAssetUsefulLife_ccd83d10-f3a7-4a43-8abc-5d8a2b14af3b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_FiniteLivedIntangibleAssetUsefulLife_ccd83d10-f3a7-4a43-8abc-5d8a2b14af3b" xlink:type="arc" order="8"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_TangibleAssetImpairmentCharges_03193c7c-03aa-4d7c-bcfc-fed557d5f00c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_TangibleAssetImpairmentCharges"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_TangibleAssetImpairmentCharges_03193c7c-03aa-4d7c-bcfc-fed557d5f00c" xlink:type="arc" order="9"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenuePerformanceObligationDescriptionOfTiming_f6f53138-e220-4f1d-9d00-9ec705d8c657" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenuePerformanceObligationDescriptionOfTiming"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_RevenuePerformanceObligationDescriptionOfTiming_f6f53138-e220-4f1d-9d00-9ec705d8c657" xlink:type="arc" order="10"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_SystemSalesArrangementWarrantyPeriod_79a3ee3f-64c1-4548-8f2e-a4bb40224781" xlink:href="isrg-20231231.xsd#isrg_SystemSalesArrangementWarrantyPeriod"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_isrg_SystemSalesArrangementWarrantyPeriod_79a3ee3f-64c1-4548-8f2e-a4bb40224781" xlink:type="arc" order="11"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AcquisitionCosts_88032ef3-4b41-46a1-935b-996c6987ae63" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AcquisitionCosts"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_AcquisitionCosts_88032ef3-4b41-46a1-935b-996c6987ae63" xlink:type="arc" order="12"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LessorOperatingLeaseTermOfContract_cf2ed01e-c1a2-40b9-ab32-6085ec6e1f8c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LessorOperatingLeaseTermOfContract"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_LessorOperatingLeaseTermOfContract_cf2ed01e-c1a2-40b9-ab32-6085ec6e1f8c" xlink:type="arc" order="13"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LessorSalesTypeLeaseTermOfContract1_c0683630-df03-43a5-9ed1-3ec5c3e735d6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LessorSalesTypeLeaseTermOfContract1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_LessorSalesTypeLeaseTermOfContract1_c0683630-df03-43a5-9ed1-3ec5c3e735d6" xlink:type="arc" order="14"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ShareBasedCompensationArrangementbySharebasedPaymentAwardFairValueAssumptionsMarketbasedImpliedVolatilityPeriod_4469f858-fe84-4086-8917-59b8683e2ea7" xlink:href="isrg-20231231.xsd#isrg_ShareBasedCompensationArrangementbySharebasedPaymentAwardFairValueAssumptionsMarketbasedImpliedVolatilityPeriod"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_isrg_ShareBasedCompensationArrangementbySharebasedPaymentAwardFairValueAssumptionsMarketbasedImpliedVolatilityPeriod_4469f858-fe84-4086-8917-59b8683e2ea7" xlink:type="arc" order="15"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ShareBasedCompensationArrangementbySharebasedPaymentAwardFairValueAssumptionsMarketbasedImpliedVolatilityPercent_2605ce4f-f9cb-4c02-884e-257ab2c9648d" xlink:href="isrg-20231231.xsd#isrg_ShareBasedCompensationArrangementbySharebasedPaymentAwardFairValueAssumptionsMarketbasedImpliedVolatilityPercent"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_isrg_ShareBasedCompensationArrangementbySharebasedPaymentAwardFairValueAssumptionsMarketbasedImpliedVolatilityPercent_2605ce4f-f9cb-4c02-884e-257ab2c9648d" xlink:type="arc" order="16"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeTermOfContract_077d3f9a-a17a-482e-bda2-5d1cea17f6f8" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeTermOfContract"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_us-gaap_DerivativeTermOfContract_077d3f9a-a17a-482e-bda2-5d1cea17f6f8" xlink:type="arc" order="17"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_DerivativeInstrumentDesignationAsCashFlowHedgesDeDesignationPeriod_ee0a32a0-9cf4-40d9-9bd0-73902fff0cfe" xlink:href="isrg-20231231.xsd#isrg_DerivativeInstrumentDesignationAsCashFlowHedgesDeDesignationPeriod"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_isrg_DerivativeInstrumentDesignationAsCashFlowHedgesDeDesignationPeriod_ee0a32a0-9cf4-40d9-9bd0-73902fff0cfe" xlink:type="arc" order="18"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_LongLivedAssetsMaintainedInTheUnitedStatesPercent_799f9735-9254-4ffd-8c8b-1ca3b8fb3988" xlink:href="isrg-20231231.xsd#isrg_LongLivedAssetsMaintainedInTheUnitedStatesPercent"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_SummaryOfSignificantAccountingPoliciesLineItems_122c8c11-10b9-434b-a852-8883f665f5e3" xlink:to="loc_isrg_LongLivedAssetsMaintainedInTheUnitedStatesPercent_799f9735-9254-4ffd-8c8b-1ca3b8fb3988" xlink:type="arc" order="19"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/SummaryOfSignificantAccountingPoliciesEstimatedUsefulLivesOfAssetsDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#SummaryOfSignificantAccountingPoliciesEstimatedUsefulLivesOfAssetsDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/SummaryOfSignificantAccountingPoliciesEstimatedUsefulLivesOfAssetsDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PropertyPlantAndEquipmentLineItems_beabd137-dc28-436a-94df-9d2c0d9a1521" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PropertyPlantAndEquipmentLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfPropertyPlantAndEquipmentTable_564f9a77-22a2-4d7a-a8c9-5a78d825cf2d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfPropertyPlantAndEquipmentTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentLineItems_beabd137-dc28-436a-94df-9d2c0d9a1521" xlink:to="loc_us-gaap_ScheduleOfPropertyPlantAndEquipmentTable_564f9a77-22a2-4d7a-a8c9-5a78d825cf2d" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PropertyPlantAndEquipmentByTypeAxis_05da46ee-9f43-4f51-bc14-6b75d8cd5353" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfPropertyPlantAndEquipmentTable_564f9a77-22a2-4d7a-a8c9-5a78d825cf2d" xlink:to="loc_us-gaap_PropertyPlantAndEquipmentByTypeAxis_05da46ee-9f43-4f51-bc14-6b75d8cd5353" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_05da46ee-9f43-4f51-bc14-6b75d8cd5353_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentByTypeAxis_05da46ee-9f43-4f51-bc14-6b75d8cd5353" xlink:to="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_05da46ee-9f43-4f51-bc14-6b75d8cd5353_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_70a54eac-6d56-4895-b13b-1b7b71688ff4" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentByTypeAxis_05da46ee-9f43-4f51-bc14-6b75d8cd5353" xlink:to="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_70a54eac-6d56-4895-b13b-1b7b71688ff4" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BuildingMember_09b90279-064e-45c7-b0c7-40618d896f2d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BuildingMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_70a54eac-6d56-4895-b13b-1b7b71688ff4" xlink:to="loc_us-gaap_BuildingMember_09b90279-064e-45c7-b0c7-40618d896f2d" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BuildingImprovementsMember_285c78ec-7da6-4a3e-b526-4a13883f27c1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BuildingImprovementsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_70a54eac-6d56-4895-b13b-1b7b71688ff4" xlink:to="loc_us-gaap_BuildingImprovementsMember_285c78ec-7da6-4a3e-b526-4a13883f27c1" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_EquipmentAndFurnitureMember_2d2e99b1-aaa7-4f55-93b3-92cd79bb6b43" xlink:href="isrg-20231231.xsd#isrg_EquipmentAndFurnitureMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_70a54eac-6d56-4895-b13b-1b7b71688ff4" xlink:to="loc_isrg_EquipmentAndFurnitureMember_2d2e99b1-aaa7-4f55-93b3-92cd79bb6b43" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OtherCapitalizedPropertyPlantAndEquipmentMember_a76e7ea9-6280-4bb5-9e93-e1456efc02b0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OtherCapitalizedPropertyPlantAndEquipmentMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_70a54eac-6d56-4895-b13b-1b7b71688ff4" xlink:to="loc_us-gaap_OtherCapitalizedPropertyPlantAndEquipmentMember_a76e7ea9-6280-4bb5-9e93-e1456efc02b0" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ComputerEquipmentMember_c5f6219d-1146-4929-89e0-08eecd308b94" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ComputerEquipmentMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_70a54eac-6d56-4895-b13b-1b7b71688ff4" xlink:to="loc_us-gaap_ComputerEquipmentMember_c5f6219d-1146-4929-89e0-08eecd308b94" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_EnterpriseWideSoftwareMember_d68dff84-6361-44cb-ad55-5381f88efed3" xlink:href="isrg-20231231.xsd#isrg_EnterpriseWideSoftwareMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_70a54eac-6d56-4895-b13b-1b7b71688ff4" xlink:to="loc_isrg_EnterpriseWideSoftwareMember_d68dff84-6361-44cb-ad55-5381f88efed3" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_PurchasedSoftwareMember_348a044d-ebfb-47c4-90de-cc2033891438" xlink:href="isrg-20231231.xsd#isrg_PurchasedSoftwareMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentTypeDomain_70a54eac-6d56-4895-b13b-1b7b71688ff4" xlink:to="loc_isrg_PurchasedSoftwareMember_348a044d-ebfb-47c4-90de-cc2033891438" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeAxis_81d2da85-b217-4fa5-a895-082a044c3718" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfPropertyPlantAndEquipmentTable_564f9a77-22a2-4d7a-a8c9-5a78d825cf2d" xlink:to="loc_srt_RangeAxis_81d2da85-b217-4fa5-a895-082a044c3718" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeMember_81d2da85-b217-4fa5-a895-082a044c3718_default" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_srt_RangeAxis_81d2da85-b217-4fa5-a895-082a044c3718" xlink:to="loc_srt_RangeMember_81d2da85-b217-4fa5-a895-082a044c3718_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeMember_3e910831-ec5d-4eb7-89a1-197fdc3cb6af" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_srt_RangeAxis_81d2da85-b217-4fa5-a895-082a044c3718" xlink:to="loc_srt_RangeMember_3e910831-ec5d-4eb7-89a1-197fdc3cb6af" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_MinimumMember_4ddf7ebb-832d-4850-830b-6f9245f7d0af" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_MinimumMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_RangeMember_3e910831-ec5d-4eb7-89a1-197fdc3cb6af" xlink:to="loc_srt_MinimumMember_4ddf7ebb-832d-4850-830b-6f9245f7d0af" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_MaximumMember_dcfd87e2-712e-428c-8c51-c703498afaf4" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_MaximumMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_RangeMember_3e910831-ec5d-4eb7-89a1-197fdc3cb6af" xlink:to="loc_srt_MaximumMember_dcfd87e2-712e-428c-8c51-c703498afaf4" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PropertyPlantAndEquipmentUsefulLife_e0abe5c5-3323-4502-a025-b826d08d641f" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PropertyPlantAndEquipmentLineItems_beabd137-dc28-436a-94df-9d2c0d9a1521" xlink:to="loc_us-gaap_PropertyPlantAndEquipmentUsefulLife_e0abe5c5-3323-4502-a025-b826d08d641f" xlink:type="arc" order="0"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/SummaryOfSignificantAccountingPoliciesAmortizedCostBasisByYearofOriginationandCreditQualityIndicatorDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#SummaryOfSignificantAccountingPoliciesAmortizedCostBasisByYearofOriginationandCreditQualityIndicatorDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/SummaryOfSignificantAccountingPoliciesAmortizedCostBasisByYearofOriginationandCreditQualityIndicatorDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems_5b6bc459-d0fa-4589-8c07-739db1e23553" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorTable_03f49132-53a0-4bbf-be4b-535c0de36919" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems_5b6bc459-d0fa-4589-8c07-739db1e23553" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorTable_03f49132-53a0-4bbf-be4b-535c0de36919" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_InternalCreditAssessmentAxis_4c2b81b8-bdc7-424e-abc3-b9f6e37ddf31" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_InternalCreditAssessmentAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorTable_03f49132-53a0-4bbf-be4b-535c0de36919" xlink:to="loc_us-gaap_InternalCreditAssessmentAxis_4c2b81b8-bdc7-424e-abc3-b9f6e37ddf31" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_InternalCreditAssessmentDomain_4c2b81b8-bdc7-424e-abc3-b9f6e37ddf31_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_InternalCreditAssessmentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_InternalCreditAssessmentAxis_4c2b81b8-bdc7-424e-abc3-b9f6e37ddf31" xlink:to="loc_us-gaap_InternalCreditAssessmentDomain_4c2b81b8-bdc7-424e-abc3-b9f6e37ddf31_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_InternalCreditAssessmentDomain_5c6438b3-72b2-4bf5-b1f8-7ee0f6f524bd" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_InternalCreditAssessmentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_InternalCreditAssessmentAxis_4c2b81b8-bdc7-424e-abc3-b9f6e37ddf31" xlink:to="loc_us-gaap_InternalCreditAssessmentDomain_5c6438b3-72b2-4bf5-b1f8-7ee0f6f524bd" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_HighCreditRatingMember_afd01d2c-7fb2-4030-aac9-1465ba3bd396" xlink:href="isrg-20231231.xsd#isrg_HighCreditRatingMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_InternalCreditAssessmentDomain_5c6438b3-72b2-4bf5-b1f8-7ee0f6f524bd" xlink:to="loc_isrg_HighCreditRatingMember_afd01d2c-7fb2-4030-aac9-1465ba3bd396" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ModerateCreditRatingMember_7fd114b8-38f8-42fb-a84b-dac5365955b9" xlink:href="isrg-20231231.xsd#isrg_ModerateCreditRatingMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_InternalCreditAssessmentDomain_5c6438b3-72b2-4bf5-b1f8-7ee0f6f524bd" xlink:to="loc_isrg_ModerateCreditRatingMember_7fd114b8-38f8-42fb-a84b-dac5365955b9" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_LowCreditRatingMember_484a1fcf-6b40-48ca-8653-ac3b79d826d6" xlink:href="isrg-20231231.xsd#isrg_LowCreditRatingMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_InternalCreditAssessmentDomain_5c6438b3-72b2-4bf5-b1f8-7ee0f6f524bd" xlink:to="loc_isrg_LowCreditRatingMember_484a1fcf-6b40-48ca-8653-ac3b79d826d6" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedInCurrentFiscalYear_440d7278-75ca-4b53-91d7-8ad94c1ded81" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedInCurrentFiscalYear"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems_5b6bc459-d0fa-4589-8c07-739db1e23553" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedInCurrentFiscalYear_440d7278-75ca-4b53-91d7-8ad94c1ded81" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedInFiscalYearBeforeLatestFiscalYear_f762bd50-190f-4c95-9778-be581e6a5860" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedInFiscalYearBeforeLatestFiscalYear"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems_5b6bc459-d0fa-4589-8c07-739db1e23553" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedInFiscalYearBeforeLatestFiscalYear_f762bd50-190f-4c95-9778-be581e6a5860" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedTwoYearsBeforeLatestFiscalYear_899db397-8825-4bbb-beb1-74f8dfc9736e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedTwoYearsBeforeLatestFiscalYear"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems_5b6bc459-d0fa-4589-8c07-739db1e23553" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedTwoYearsBeforeLatestFiscalYear_899db397-8825-4bbb-beb1-74f8dfc9736e" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedThreeYearsBeforeLatestFiscalYear_3c2202c2-6c5f-4590-bf34-a38f94d51c10" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedThreeYearsBeforeLatestFiscalYear"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems_5b6bc459-d0fa-4589-8c07-739db1e23553" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedThreeYearsBeforeLatestFiscalYear_3c2202c2-6c5f-4590-bf34-a38f94d51c10" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedFourYearsBeforeLatestFiscalYear_71957fca-c0bc-4c97-8ef3-f49241f7b06b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedFourYearsBeforeLatestFiscalYear"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems_5b6bc459-d0fa-4589-8c07-739db1e23553" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedFourYearsBeforeLatestFiscalYear_71957fca-c0bc-4c97-8ef3-f49241f7b06b" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedFiveOrMoreYearsBeforeLatestFiscalYear_e346cdfb-69ee-4bdf-a0d2-cbe32b8f9c4a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedFiveOrMoreYearsBeforeLatestFiscalYear"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems_5b6bc459-d0fa-4589-8c07-739db1e23553" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseOriginatedFiveOrMoreYearsBeforeLatestFiscalYear_e346cdfb-69ee-4bdf-a0d2-cbe32b8f9c4a" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLease_eef6b53e-0a6e-4383-b96f-f04167f62477" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLease"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseCreditQualityIndicatorLineItems_5b6bc459-d0fa-4589-8c07-739db1e23553" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLease_eef6b53e-0a6e-4383-b96f-f04167f62477" xlink:type="arc" order="6"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/FinancialInstrumentsSummaryOfCashAndAvailableForSaleSecuritiesDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#FinancialInstrumentsSummaryOfCashAndAvailableForSaleSecuritiesDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/FinancialInstrumentsSummaryOfCashAndAvailableForSaleSecuritiesDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DebtSecuritiesAvailableForSaleTable_2276c637-7903-4387-a4a1-93f4c796901c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DebtSecuritiesAvailableForSaleTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_DebtSecuritiesAvailableForSaleTable_2276c637-7903-4387-a4a1-93f4c796901c" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_95323702-6be3-48a7-b23b-b348423703bb" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_DebtSecuritiesAvailableForSaleTable_2276c637-7903-4387-a4a1-93f4c796901c" xlink:to="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_95323702-6be3-48a7-b23b-b348423703bb" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_95323702-6be3-48a7-b23b-b348423703bb_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_95323702-6be3-48a7-b23b-b348423703bb" xlink:to="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_95323702-6be3-48a7-b23b-b348423703bb_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_d17ea016-b25a-4df5-8791-da39b52eb4f4" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_95323702-6be3-48a7-b23b-b348423703bb" xlink:to="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_d17ea016-b25a-4df5-8791-da39b52eb4f4" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueInputsLevel1Member_162d42ba-bbf1-4805-ab01-69620b1ef064" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueInputsLevel1Member"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_d17ea016-b25a-4df5-8791-da39b52eb4f4" xlink:to="loc_us-gaap_FairValueInputsLevel1Member_162d42ba-bbf1-4805-ab01-69620b1ef064" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueInputsLevel2Member_04b3a0ac-80b4-4385-926e-a9f505a22a65" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueInputsLevel2Member"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_d17ea016-b25a-4df5-8791-da39b52eb4f4" xlink:to="loc_us-gaap_FairValueInputsLevel2Member_04b3a0ac-80b4-4385-926e-a9f505a22a65" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FinancialInstrumentAxis_5a3cd8c0-bf4a-47bb-85ab-4e59cc3547d4" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FinancialInstrumentAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_DebtSecuritiesAvailableForSaleTable_2276c637-7903-4387-a4a1-93f4c796901c" xlink:to="loc_us-gaap_FinancialInstrumentAxis_5a3cd8c0-bf4a-47bb-85ab-4e59cc3547d4" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_5a3cd8c0-bf4a-47bb-85ab-4e59cc3547d4_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_FinancialInstrumentAxis_5a3cd8c0-bf4a-47bb-85ab-4e59cc3547d4" xlink:to="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_5a3cd8c0-bf4a-47bb-85ab-4e59cc3547d4_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_f12445bc-d874-4d02-8eac-b887e93c62ae" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_FinancialInstrumentAxis_5a3cd8c0-bf4a-47bb-85ab-4e59cc3547d4" xlink:to="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_f12445bc-d874-4d02-8eac-b887e93c62ae" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CashMember_5c2372ed-0ba1-491e-879e-ec373bb8e11c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CashMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_f12445bc-d874-4d02-8eac-b887e93c62ae" xlink:to="loc_us-gaap_CashMember_5c2372ed-0ba1-491e-879e-ec373bb8e11c" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_MoneyMarketFundsMember_90fb3086-6d0d-48ae-a749-0aa68eca1ae8" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_MoneyMarketFundsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_f12445bc-d874-4d02-8eac-b887e93c62ae" xlink:to="loc_us-gaap_MoneyMarketFundsMember_90fb3086-6d0d-48ae-a749-0aa68eca1ae8" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_USTreasurySecuritiesMember_feaad1fa-e4e7-4d69-ba1b-edd92d91b305" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_USTreasurySecuritiesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_f12445bc-d874-4d02-8eac-b887e93c62ae" xlink:to="loc_us-gaap_USTreasurySecuritiesMember_feaad1fa-e4e7-4d69-ba1b-edd92d91b305" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CommercialPaperMember_624485ff-5866-49b2-af6c-79fb7fd6a4fa" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CommercialPaperMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_f12445bc-d874-4d02-8eac-b887e93c62ae" xlink:to="loc_us-gaap_CommercialPaperMember_624485ff-5866-49b2-af6c-79fb7fd6a4fa" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CorporateDebtSecuritiesMember_c75bf00d-6f83-4794-84ac-64ecabc6c457" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CorporateDebtSecuritiesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_f12445bc-d874-4d02-8eac-b887e93c62ae" xlink:to="loc_us-gaap_CorporateDebtSecuritiesMember_c75bf00d-6f83-4794-84ac-64ecabc6c457" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_USGovernmentAgenciesDebtSecuritiesMember_e0b69db1-11b4-4b40-8af7-b1469c79c673" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_USGovernmentAgenciesDebtSecuritiesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_f12445bc-d874-4d02-8eac-b887e93c62ae" xlink:to="loc_us-gaap_USGovernmentAgenciesDebtSecuritiesMember_e0b69db1-11b4-4b40-8af7-b1469c79c673" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_MunicipalNotesMember_29fce37e-bafa-4389-aa15-68f07b539dbc" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_MunicipalNotesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain_f12445bc-d874-4d02-8eac-b887e93c62ae" xlink:to="loc_us-gaap_MunicipalNotesMember_29fce37e-bafa-4389-aa15-68f07b539dbc" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CashAndCashEquivalentsAtCarryingValue_52d0e9d2-37ee-4937-9ef1-31e260773d9f" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_CashAndCashEquivalentsAtCarryingValue_52d0e9d2-37ee-4937-9ef1-31e260773d9f" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CashAndCashEquivalentsFairValueDisclosure_ddfb9a37-c716-4bf3-81b9-f0d33d508c17" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CashAndCashEquivalentsFairValueDisclosure"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_CashAndCashEquivalentsFairValueDisclosure_ddfb9a37-c716-4bf3-81b9-f0d33d508c17" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AvailableForSaleDebtSecuritiesAmortizedCostBasis_434e89d1-4403-4a30-b7b5-34a4ec01c192" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AvailableForSaleDebtSecuritiesAmortizedCostBasis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_AvailableForSaleDebtSecuritiesAmortizedCostBasis_434e89d1-4403-4a30-b7b5-34a4ec01c192" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CashandCashEquivalentsandDebtSecuritiesAvailableforsaleAmortizedCost_0dad5d0e-1427-433a-887c-7df10d837d6c" xlink:href="isrg-20231231.xsd#isrg_CashandCashEquivalentsandDebtSecuritiesAvailableforsaleAmortizedCost"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_isrg_CashandCashEquivalentsandDebtSecuritiesAvailableforsaleAmortizedCost_0dad5d0e-1427-433a-887c-7df10d837d6c" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedGainBeforeTax_73dfc78a-abf3-4ae6-b484-d73145f2c497" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedGainBeforeTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedGainBeforeTax_73dfc78a-abf3-4ae6-b484-d73145f2c497" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedLossBeforeTax_1e7fdbb9-1b7f-43fd-89f3-44e0abf64f39" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedLossBeforeTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedLossBeforeTax_1e7fdbb9-1b7f-43fd-89f3-44e0abf64f39" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DebtSecuritiesAvailableForSaleAllowanceForCreditLoss_8b89d5f4-e602-477f-a74f-2848a6e4df37" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DebtSecuritiesAvailableForSaleAllowanceForCreditLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_DebtSecuritiesAvailableForSaleAllowanceForCreditLoss_8b89d5f4-e602-477f-a74f-2848a6e4df37" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AvailableForSaleSecuritiesDebtSecurities_3853749a-67cf-40a8-9051-2a2b7c802861" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AvailableForSaleSecuritiesDebtSecurities"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_AvailableForSaleSecuritiesDebtSecurities_3853749a-67cf-40a8-9051-2a2b7c802861" xlink:type="arc" order="7"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CashandCashEquivalentsandDebtSecuritiesAvailableforsaleFairValue_e2483933-8323-4423-adbd-f1b9182d3b9b" xlink:href="isrg-20231231.xsd#isrg_CashandCashEquivalentsandDebtSecuritiesAvailableforsaleFairValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_isrg_CashandCashEquivalentsandDebtSecuritiesAvailableforsaleFairValue_e2483933-8323-4423-adbd-f1b9182d3b9b" xlink:type="arc" order="8"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_MarketableSecuritiesCurrent_52057cc8-c256-4b94-90a5-09a3c4eb13aa" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_MarketableSecuritiesCurrent"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_MarketableSecuritiesCurrent_52057cc8-c256-4b94-90a5-09a3c4eb13aa" xlink:type="arc" order="9"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_MarketableSecuritiesNoncurrent_b37c54e2-a7b3-4891-be77-a54e6794d86c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_MarketableSecuritiesNoncurrent"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_7cf7f0a5-8bc3-4813-afb7-faa81fc2a2ec" xlink:to="loc_us-gaap_MarketableSecuritiesNoncurrent_b37c54e2-a7b3-4891-be77-a54e6794d86c" xlink:type="arc" order="10"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/FinancialInstrumentsAdditionalInformationDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#FinancialInstrumentsAdditionalInformationDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/FinancialInstrumentsAdditionalInformationDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueBalanceSheetGroupingFinancialStatementCaptionsLineItems_98973eed-1352-4814-9377-5eadbe8c5509" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueBalanceSheetGroupingFinancialStatementCaptionsLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueByBalanceSheetGroupingTable_b94d8749-4b0c-4a70-a148-fbc6fc49f1f6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueByBalanceSheetGroupingTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_FairValueBalanceSheetGroupingFinancialStatementCaptionsLineItems_98973eed-1352-4814-9377-5eadbe8c5509" xlink:to="loc_us-gaap_FairValueByBalanceSheetGroupingTable_b94d8749-4b0c-4a70-a148-fbc6fc49f1f6" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_03b95092-482d-42ec-ad28-bc1ff38ce415" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_FairValueByBalanceSheetGroupingTable_b94d8749-4b0c-4a70-a148-fbc6fc49f1f6" xlink:to="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_03b95092-482d-42ec-ad28-bc1ff38ce415" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_03b95092-482d-42ec-ad28-bc1ff38ce415_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_03b95092-482d-42ec-ad28-bc1ff38ce415" xlink:to="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_03b95092-482d-42ec-ad28-bc1ff38ce415_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_607ab58a-ead8-42e8-9d34-621556a1e12f" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_03b95092-482d-42ec-ad28-bc1ff38ce415" xlink:to="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_607ab58a-ead8-42e8-9d34-621556a1e12f" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueInputsLevel2Member_9c912e08-29c1-4d8c-8a5b-9d96d9f4dcc3" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueInputsLevel2Member"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_607ab58a-ead8-42e8-9d34-621556a1e12f" xlink:to="loc_us-gaap_FairValueInputsLevel2Member_9c912e08-29c1-4d8c-8a5b-9d96d9f4dcc3" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeAxis_80b86edf-6a44-41e6-bb0e-484ac05696d0" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_FairValueByBalanceSheetGroupingTable_b94d8749-4b0c-4a70-a148-fbc6fc49f1f6" xlink:to="loc_srt_RangeAxis_80b86edf-6a44-41e6-bb0e-484ac05696d0" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeMember_80b86edf-6a44-41e6-bb0e-484ac05696d0_default" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_srt_RangeAxis_80b86edf-6a44-41e6-bb0e-484ac05696d0" xlink:to="loc_srt_RangeMember_80b86edf-6a44-41e6-bb0e-484ac05696d0_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeMember_f9926e72-4744-4b8d-9e7c-db4f8f4a20a7" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_srt_RangeAxis_80b86edf-6a44-41e6-bb0e-484ac05696d0" xlink:to="loc_srt_RangeMember_f9926e72-4744-4b8d-9e7c-db4f8f4a20a7" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_MaximumMember_17a7c101-380f-4080-9fa2-a0c44c068e80" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_MaximumMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_RangeMember_f9926e72-4744-4b8d-9e7c-db4f8f4a20a7" xlink:to="loc_srt_MaximumMember_17a7c101-380f-4080-9fa2-a0c44c068e80" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_UnrealizedGainLossOnInvestments_d40fe1f4-98cd-4202-b953-905250e3b5a8" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_UnrealizedGainLossOnInvestments"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueBalanceSheetGroupingFinancialStatementCaptionsLineItems_98973eed-1352-4814-9377-5eadbe8c5509" xlink:to="loc_us-gaap_UnrealizedGainLossOnInvestments_d40fe1f4-98cd-4202-b953-905250e3b5a8" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_EquitySecuritiesWithoutReadilyDeterminableFairValueUnrealizedGainLoss_cd87a7e8-4f69-4bbe-9f5d-0683553edf45" xlink:href="isrg-20231231.xsd#isrg_EquitySecuritiesWithoutReadilyDeterminableFairValueUnrealizedGainLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueBalanceSheetGroupingFinancialStatementCaptionsLineItems_98973eed-1352-4814-9377-5eadbe8c5509" xlink:to="loc_isrg_EquitySecuritiesWithoutReadilyDeterminableFairValueUnrealizedGainLoss_cd87a7e8-4f69-4bbe-9f5d-0683553edf45" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeTermOfContract_f46a9ef3-4ca4-433a-a77f-deadc55b76d6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeTermOfContract"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueBalanceSheetGroupingFinancialStatementCaptionsLineItems_98973eed-1352-4814-9377-5eadbe8c5509" xlink:to="loc_us-gaap_DerivativeTermOfContract_f46a9ef3-4ca4-433a-a77f-deadc55b76d6" xlink:type="arc" order="2"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/FinancialInstrumentsScheduleOfAvailableForSaleInvestmentsWithUnrealizedLossesDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#FinancialInstrumentsScheduleOfAvailableForSaleInvestmentsWithUnrealizedLossesDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/FinancialInstrumentsScheduleOfAvailableForSaleInvestmentsWithUnrealizedLossesDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_058ce5a2-5a2e-4fa6-83f9-28eff92a71f8" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DebtSecuritiesAvailableForSaleTable_a1e7dfc7-dedb-4664-9fcd-6c88f9c5f1fa" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DebtSecuritiesAvailableForSaleTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_058ce5a2-5a2e-4fa6-83f9-28eff92a71f8" xlink:to="loc_us-gaap_DebtSecuritiesAvailableForSaleTable_a1e7dfc7-dedb-4664-9fcd-6c88f9c5f1fa" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ScheduleOfAvailableForSaleSecuritiesAxis_308cc895-3c9d-4eaa-ba0b-b6cc561da04e" xlink:href="isrg-20231231.xsd#isrg_ScheduleOfAvailableForSaleSecuritiesAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_DebtSecuritiesAvailableForSaleTable_a1e7dfc7-dedb-4664-9fcd-6c88f9c5f1fa" xlink:to="loc_isrg_ScheduleOfAvailableForSaleSecuritiesAxis_308cc895-3c9d-4eaa-ba0b-b6cc561da04e" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain_308cc895-3c9d-4eaa-ba0b-b6cc561da04e_default" xlink:href="isrg-20231231.xsd#isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_isrg_ScheduleOfAvailableForSaleSecuritiesAxis_308cc895-3c9d-4eaa-ba0b-b6cc561da04e" xlink:to="loc_isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain_308cc895-3c9d-4eaa-ba0b-b6cc561da04e_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain_780f46ec-f6c2-4085-b93e-a5edab5c3a52" xlink:href="isrg-20231231.xsd#isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_isrg_ScheduleOfAvailableForSaleSecuritiesAxis_308cc895-3c9d-4eaa-ba0b-b6cc561da04e" xlink:to="loc_isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain_780f46ec-f6c2-4085-b93e-a5edab5c3a52" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_USTreasurySecuritiesMember_3999cc4b-164d-4897-a085-97d4a9e5d568" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_USTreasurySecuritiesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain_780f46ec-f6c2-4085-b93e-a5edab5c3a52" xlink:to="loc_us-gaap_USTreasurySecuritiesMember_3999cc4b-164d-4897-a085-97d4a9e5d568" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CorporateNoteSecuritiesMember_bef5471a-8206-400c-b66e-0984f627ceb1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CorporateNoteSecuritiesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain_780f46ec-f6c2-4085-b93e-a5edab5c3a52" xlink:to="loc_us-gaap_CorporateNoteSecuritiesMember_bef5471a-8206-400c-b66e-0984f627ceb1" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_USTreasuryAndGovernmentMember_3762f68a-da57-4f06-9630-4e1b741b3e46" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_USTreasuryAndGovernmentMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain_780f46ec-f6c2-4085-b93e-a5edab5c3a52" xlink:to="loc_us-gaap_USTreasuryAndGovernmentMember_3762f68a-da57-4f06-9630-4e1b741b3e46" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_MunicipalNotesMember_675002ae-1490-4cfe-9e08-5ff233c35732" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_MunicipalNotesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_ScheduleOfAvailableForSaleAndHeldToMaturitySecuritiesDomain_780f46ec-f6c2-4085-b93e-a5edab5c3a52" xlink:to="loc_us-gaap_MunicipalNotesMember_675002ae-1490-4cfe-9e08-5ff233c35732" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12Months_d0212549-5582-42f7-bc4d-54acfe92b050" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12Months"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_058ce5a2-5a2e-4fa6-83f9-28eff92a71f8" xlink:to="loc_us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12Months_d0212549-5582-42f7-bc4d-54acfe92b050" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12MonthsAccumulatedLoss_d54d5d7b-aa51-4d98-b44b-ad22fd196648" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12MonthsAccumulatedLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_058ce5a2-5a2e-4fa6-83f9-28eff92a71f8" xlink:to="loc_us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12MonthsAccumulatedLoss_d54d5d7b-aa51-4d98-b44b-ad22fd196648" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLonger_1696232d-290b-42ee-b107-86b1e1d3a84d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLonger"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_058ce5a2-5a2e-4fa6-83f9-28eff92a71f8" xlink:to="loc_us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLonger_1696232d-290b-42ee-b107-86b1e1d3a84d" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLongerAccumulatedLoss_7da196a0-f722-4c36-a892-beb51fbf969e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLongerAccumulatedLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_058ce5a2-5a2e-4fa6-83f9-28eff92a71f8" xlink:to="loc_us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLongerAccumulatedLoss_7da196a0-f722-4c36-a892-beb51fbf969e" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPosition_c57e0dcf-2f6c-437b-beef-fca64e8a822d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPosition"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_058ce5a2-5a2e-4fa6-83f9-28eff92a71f8" xlink:to="loc_us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPosition_c57e0dcf-2f6c-437b-beef-fca64e8a822d" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionAccumulatedLoss_332d2fe8-3a2b-4678-8677-dd906c51bdc1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionAccumulatedLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems_058ce5a2-5a2e-4fa6-83f9-28eff92a71f8" xlink:to="loc_us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionAccumulatedLoss_332d2fe8-3a2b-4678-8677-dd906c51bdc1" xlink:type="arc" order="5"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/FinancialInstrumentsSummaryofEquityInvestmentActivityDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#FinancialInstrumentsSummaryofEquityInvestmentActivityDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/FinancialInstrumentsSummaryofEquityInvestmentActivityDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsLineItems_58bcd1dd-b3e2-4c72-a09b-06111e725438" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsTable_d3619c1f-8ad3-4466-b4b3-8ee3267bde6b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsLineItems_58bcd1dd-b3e2-4c72-a09b-06111e725438" xlink:to="loc_us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsTable_d3619c1f-8ad3-4466-b4b3-8ee3267bde6b" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BalanceSheetLocationAxis_01d90354-a2c5-481c-992b-efd9dc0eabdc" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BalanceSheetLocationAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsTable_d3619c1f-8ad3-4466-b4b3-8ee3267bde6b" xlink:to="loc_us-gaap_BalanceSheetLocationAxis_01d90354-a2c5-481c-992b-efd9dc0eabdc" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BalanceSheetLocationDomain_01d90354-a2c5-481c-992b-efd9dc0eabdc_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BalanceSheetLocationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_BalanceSheetLocationAxis_01d90354-a2c5-481c-992b-efd9dc0eabdc" xlink:to="loc_us-gaap_BalanceSheetLocationDomain_01d90354-a2c5-481c-992b-efd9dc0eabdc_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BalanceSheetLocationDomain_918f6d61-5c2a-4860-b096-baef61dd348a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BalanceSheetLocationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_BalanceSheetLocationAxis_01d90354-a2c5-481c-992b-efd9dc0eabdc" xlink:to="loc_us-gaap_BalanceSheetLocationDomain_918f6d61-5c2a-4860-b096-baef61dd348a" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PrepaidExpensesAndOtherCurrentAssetsMember_07f30354-bcac-4393-8745-658756f07125" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PrepaidExpensesAndOtherCurrentAssetsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_BalanceSheetLocationDomain_918f6d61-5c2a-4860-b096-baef61dd348a" xlink:to="loc_us-gaap_PrepaidExpensesAndOtherCurrentAssetsMember_07f30354-bcac-4393-8745-658756f07125" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_IntangibleAndOtherAssetsNetMember_266b4cfa-85e1-4838-889f-6bccdafcfe3d" xlink:href="isrg-20231231.xsd#isrg_IntangibleAndOtherAssetsNetMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_BalanceSheetLocationDomain_918f6d61-5c2a-4860-b096-baef61dd348a" xlink:to="loc_isrg_IntangibleAndOtherAssetsNetMember_266b4cfa-85e1-4838-889f-6bccdafcfe3d" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_e0e74342-2562-4f06-914d-1b876c08ec4a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsTable_d3619c1f-8ad3-4466-b4b3-8ee3267bde6b" xlink:to="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_e0e74342-2562-4f06-914d-1b876c08ec4a" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_e0e74342-2562-4f06-914d-1b876c08ec4a_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_e0e74342-2562-4f06-914d-1b876c08ec4a" xlink:to="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_e0e74342-2562-4f06-914d-1b876c08ec4a_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_df28f8ce-9e3a-408a-8105-c9b0da2f568b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_FairValueByFairValueHierarchyLevelAxis_e0e74342-2562-4f06-914d-1b876c08ec4a" xlink:to="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_df28f8ce-9e3a-408a-8105-c9b0da2f568b" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueInputsLevel1Member_b008f733-aadc-4134-8a1b-6f2386b325ad" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueInputsLevel1Member"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_df28f8ce-9e3a-408a-8105-c9b0da2f568b" xlink:to="loc_us-gaap_FairValueInputsLevel1Member_b008f733-aadc-4134-8a1b-6f2386b325ad" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueInputsLevel2Member_b47d00e1-4076-464e-abb1-46d9ef9e3144" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueInputsLevel2Member"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueMeasurementsFairValueHierarchyDomain_df28f8ce-9e3a-408a-8105-c9b0da2f568b" xlink:to="loc_us-gaap_FairValueInputsLevel2Member_b47d00e1-4076-464e-abb1-46d9ef9e3144" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueAssetsMeasuredOnRecurringBasisUnobservableInputReconciliationCalculationRollForward_6d00e482-d98a-4a33-afba-27a134d046b4" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueAssetsMeasuredOnRecurringBasisUnobservableInputReconciliationCalculationRollForward"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsLineItems_58bcd1dd-b3e2-4c72-a09b-06111e725438" xlink:to="loc_us-gaap_FairValueAssetsMeasuredOnRecurringBasisUnobservableInputReconciliationCalculationRollForward_6d00e482-d98a-4a33-afba-27a134d046b4" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_FairValueLevel1RollForward_a7e8d7f9-b12d-40b5-bf70-99491242c2b1" xlink:href="isrg-20231231.xsd#isrg_FairValueLevel1RollForward"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueAssetsMeasuredOnRecurringBasisUnobservableInputReconciliationCalculationRollForward_6d00e482-d98a-4a33-afba-27a134d046b4" xlink:to="loc_isrg_FairValueLevel1RollForward_a7e8d7f9-b12d-40b5-bf70-99491242c2b1" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquitySecuritiesFvNi_0323038a-8de2-440a-a6ea-fd50a4477b05" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquitySecuritiesFvNi"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_FairValueLevel1RollForward_a7e8d7f9-b12d-40b5-bf70-99491242c2b1" xlink:to="loc_us-gaap_EquitySecuritiesFvNi_0323038a-8de2-440a-a6ea-fd50a4477b05" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquitySecuritiesFvNiUnrealizedGainLoss_bebc1c62-1b34-4d2e-b2aa-204a3ae6a4f9" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquitySecuritiesFvNiUnrealizedGainLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_FairValueLevel1RollForward_a7e8d7f9-b12d-40b5-bf70-99491242c2b1" xlink:to="loc_us-gaap_EquitySecuritiesFvNiUnrealizedGainLoss_bebc1c62-1b34-4d2e-b2aa-204a3ae6a4f9" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_EquitySecuritiesFVNISalesPurchasesAndOtherAdjustments_9c5a7747-bb80-486b-9b7b-d7b8d2e51926" xlink:href="isrg-20231231.xsd#isrg_EquitySecuritiesFVNISalesPurchasesAndOtherAdjustments"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_FairValueLevel1RollForward_a7e8d7f9-b12d-40b5-bf70-99491242c2b1" xlink:to="loc_isrg_EquitySecuritiesFVNISalesPurchasesAndOtherAdjustments_9c5a7747-bb80-486b-9b7b-d7b8d2e51926" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquitySecuritiesFvNi_69d83f8f-13c3-4b66-be2c-8c5c26f0ba2c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquitySecuritiesFvNi"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_FairValueLevel2RollForward_7e13b09d-7c81-4f9f-a7aa-c1d73d14c943" xlink:href="isrg-20231231.xsd#isrg_FairValueLevel2RollForward"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueAssetsMeasuredOnRecurringBasisUnobservableInputReconciliationCalculationRollForward_6d00e482-d98a-4a33-afba-27a134d046b4" xlink:to="loc_isrg_FairValueLevel2RollForward_7e13b09d-7c81-4f9f-a7aa-c1d73d14c943" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValueAmount_65b9f139-6b94-4cf9-b4e3-edf06601ed43" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValueAmount"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_FairValueLevel2RollForward_7e13b09d-7c81-4f9f-a7aa-c1d73d14c943" xlink:to="loc_us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValueAmount_65b9f139-6b94-4cf9-b4e3-edf06601ed43" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_EquitySecuritiesWithoutReadilyDeterminableFairValueUnrealizedGainLoss_23d52de8-9e4f-453b-84c5-938155eb55dc" xlink:href="isrg-20231231.xsd#isrg_EquitySecuritiesWithoutReadilyDeterminableFairValueUnrealizedGainLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_FairValueLevel2RollForward_7e13b09d-7c81-4f9f-a7aa-c1d73d14c943" xlink:to="loc_isrg_EquitySecuritiesWithoutReadilyDeterminableFairValueUnrealizedGainLoss_23d52de8-9e4f-453b-84c5-938155eb55dc" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_EquitySecuritiesWithoutReadilyDeterminableFairValueSalesPurchasesAndOtherAdjustments_1f292e8f-6fd8-4f49-854d-cae0f5753461" xlink:href="isrg-20231231.xsd#isrg_EquitySecuritiesWithoutReadilyDeterminableFairValueSalesPurchasesAndOtherAdjustments"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_FairValueLevel2RollForward_7e13b09d-7c81-4f9f-a7aa-c1d73d14c943" xlink:to="loc_isrg_EquitySecuritiesWithoutReadilyDeterminableFairValueSalesPurchasesAndOtherAdjustments_1f292e8f-6fd8-4f49-854d-cae0f5753461" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValueAmount_ae908cd3-eece-4007-b787-5532c74587f0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValueAmount"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/FinancialInstrumentsDerivativeInstrumentsUsedtoHedgeagainstBalanceSheetForeignCurrencyExposuresDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#FinancialInstrumentsDerivativeInstrumentsUsedtoHedgeagainstBalanceSheetForeignCurrencyExposuresDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/FinancialInstrumentsDerivativeInstrumentsUsedtoHedgeagainstBalanceSheetForeignCurrencyExposuresDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems_50d3fab4-87a2-4613-8eb6-39ff10abe198" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable_ce882d93-24b8-4c71-b473-8e0370b35176" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems_50d3fab4-87a2-4613-8eb6-39ff10abe198" xlink:to="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable_ce882d93-24b8-4c71-b473-8e0370b35176" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeInstrumentRiskAxis_270bdfa6-24db-46c9-bfa0-a8ed995c18e6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeInstrumentRiskAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable_ce882d93-24b8-4c71-b473-8e0370b35176" xlink:to="loc_us-gaap_DerivativeInstrumentRiskAxis_270bdfa6-24db-46c9-bfa0-a8ed995c18e6" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeContractTypeDomain_270bdfa6-24db-46c9-bfa0-a8ed995c18e6_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeContractTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_DerivativeInstrumentRiskAxis_270bdfa6-24db-46c9-bfa0-a8ed995c18e6" xlink:to="loc_us-gaap_DerivativeContractTypeDomain_270bdfa6-24db-46c9-bfa0-a8ed995c18e6_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeContractTypeDomain_02b12e20-9c8b-4c8f-929a-afa382cf4de4" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeContractTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_DerivativeInstrumentRiskAxis_270bdfa6-24db-46c9-bfa0-a8ed995c18e6" xlink:to="loc_us-gaap_DerivativeContractTypeDomain_02b12e20-9c8b-4c8f-929a-afa382cf4de4" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ForeignExchangeForwardMember_30ae256c-0709-4246-90fc-07aedcd8f9cf" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ForeignExchangeForwardMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_DerivativeContractTypeDomain_02b12e20-9c8b-4c8f-929a-afa382cf4de4" xlink:to="loc_us-gaap_ForeignExchangeForwardMember_30ae256c-0709-4246-90fc-07aedcd8f9cf" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_HedgingDesignationAxis_f9518afc-1f13-486c-afc2-8dfff1bed137" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_HedgingDesignationAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable_ce882d93-24b8-4c71-b473-8e0370b35176" xlink:to="loc_us-gaap_HedgingDesignationAxis_f9518afc-1f13-486c-afc2-8dfff1bed137" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_HedgingDesignationDomain_f9518afc-1f13-486c-afc2-8dfff1bed137_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_HedgingDesignationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_HedgingDesignationAxis_f9518afc-1f13-486c-afc2-8dfff1bed137" xlink:to="loc_us-gaap_HedgingDesignationDomain_f9518afc-1f13-486c-afc2-8dfff1bed137_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_HedgingDesignationDomain_cc727e72-1c6f-4c58-b5e4-e917ca2b1c18" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_HedgingDesignationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_HedgingDesignationAxis_f9518afc-1f13-486c-afc2-8dfff1bed137" xlink:to="loc_us-gaap_HedgingDesignationDomain_cc727e72-1c6f-4c58-b5e4-e917ca2b1c18" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_NondesignatedMember_1d39f21a-bb9d-44bd-8fc2-f2ef7b4aab89" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_NondesignatedMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_HedgingDesignationDomain_cc727e72-1c6f-4c58-b5e4-e917ca2b1c18" xlink:to="loc_us-gaap_NondesignatedMember_1d39f21a-bb9d-44bd-8fc2-f2ef7b4aab89" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeGainLossStatementOfIncomeOrComprehensiveIncomeExtensibleEnumeration_d8ae7b03-1d64-42d5-90d9-dbefeefa4818" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeGainLossStatementOfIncomeOrComprehensiveIncomeExtensibleEnumeration"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems_50d3fab4-87a2-4613-8eb6-39ff10abe198" xlink:to="loc_us-gaap_DerivativeGainLossStatementOfIncomeOrComprehensiveIncomeExtensibleEnumeration_d8ae7b03-1d64-42d5-90d9-dbefeefa4818" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeGainLossOnDerivativeNet_247e552e-0149-4a04-8862-668c4b66e396" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeGainLossOnDerivativeNet"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems_50d3fab4-87a2-4613-8eb6-39ff10abe198" xlink:to="loc_us-gaap_DerivativeGainLossOnDerivativeNet_247e552e-0149-4a04-8862-668c4b66e396" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ForeignCurrencyTransactionGainLossBeforeTax_30b47af9-1076-4027-8484-4643d60f141e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ForeignCurrencyTransactionGainLossBeforeTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems_50d3fab4-87a2-4613-8eb6-39ff10abe198" xlink:to="loc_us-gaap_ForeignCurrencyTransactionGainLossBeforeTax_30b47af9-1076-4027-8484-4643d60f141e" xlink:type="arc" order="2"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/FinancialInstrumentsGrossNotionalAmountsforOutstandingDerivativesDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#FinancialInstrumentsGrossNotionalAmountsforOutstandingDerivativesDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/FinancialInstrumentsGrossNotionalAmountsforOutstandingDerivativesDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems_153e15cb-cff1-4b54-8d65-c761c9043710" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable_7d61014f-9d54-4cdb-8934-47b1957efd74" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems_153e15cb-cff1-4b54-8d65-c761c9043710" xlink:to="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable_7d61014f-9d54-4cdb-8934-47b1957efd74" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeInstrumentRiskAxis_e8af4b6d-3c28-4519-b64e-aa65e877ee96" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeInstrumentRiskAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable_7d61014f-9d54-4cdb-8934-47b1957efd74" xlink:to="loc_us-gaap_DerivativeInstrumentRiskAxis_e8af4b6d-3c28-4519-b64e-aa65e877ee96" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeContractTypeDomain_e8af4b6d-3c28-4519-b64e-aa65e877ee96_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeContractTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_DerivativeInstrumentRiskAxis_e8af4b6d-3c28-4519-b64e-aa65e877ee96" xlink:to="loc_us-gaap_DerivativeContractTypeDomain_e8af4b6d-3c28-4519-b64e-aa65e877ee96_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeContractTypeDomain_eadb5b24-0b92-49b8-be1d-b6ae6552a239" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeContractTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_DerivativeInstrumentRiskAxis_e8af4b6d-3c28-4519-b64e-aa65e877ee96" xlink:to="loc_us-gaap_DerivativeContractTypeDomain_eadb5b24-0b92-49b8-be1d-b6ae6552a239" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ForeignExchangeForwardMember_6c6661f3-1776-4a53-9703-d547630f648e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ForeignExchangeForwardMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_DerivativeContractTypeDomain_eadb5b24-0b92-49b8-be1d-b6ae6552a239" xlink:to="loc_us-gaap_ForeignExchangeForwardMember_6c6661f3-1776-4a53-9703-d547630f648e" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_HedgingDesignationAxis_ac42afe5-7920-4266-b4e0-4f5bdda46988" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_HedgingDesignationAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable_7d61014f-9d54-4cdb-8934-47b1957efd74" xlink:to="loc_us-gaap_HedgingDesignationAxis_ac42afe5-7920-4266-b4e0-4f5bdda46988" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_HedgingDesignationDomain_ac42afe5-7920-4266-b4e0-4f5bdda46988_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_HedgingDesignationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_HedgingDesignationAxis_ac42afe5-7920-4266-b4e0-4f5bdda46988" xlink:to="loc_us-gaap_HedgingDesignationDomain_ac42afe5-7920-4266-b4e0-4f5bdda46988_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_HedgingDesignationDomain_0a1a890f-c938-4913-a0f5-1a2facbe9f05" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_HedgingDesignationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_HedgingDesignationAxis_ac42afe5-7920-4266-b4e0-4f5bdda46988" xlink:to="loc_us-gaap_HedgingDesignationDomain_0a1a890f-c938-4913-a0f5-1a2facbe9f05" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DesignatedAsHedgingInstrumentMember_0448c24d-c96a-4314-b7f6-ec659c96223a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DesignatedAsHedgingInstrumentMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_HedgingDesignationDomain_0a1a890f-c938-4913-a0f5-1a2facbe9f05" xlink:to="loc_us-gaap_DesignatedAsHedgingInstrumentMember_0448c24d-c96a-4314-b7f6-ec659c96223a" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_NondesignatedMember_d33c3a95-f988-4a01-b6cd-d107f8600aba" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_NondesignatedMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_HedgingDesignationDomain_0a1a890f-c938-4913-a0f5-1a2facbe9f05" xlink:to="loc_us-gaap_NondesignatedMember_d33c3a95-f988-4a01-b6cd-d107f8600aba" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BalanceSheetLocationAxis_5144fcf4-e50c-45cd-b7d0-df1a22f0c22f" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BalanceSheetLocationAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable_7d61014f-9d54-4cdb-8934-47b1957efd74" xlink:to="loc_us-gaap_BalanceSheetLocationAxis_5144fcf4-e50c-45cd-b7d0-df1a22f0c22f" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BalanceSheetLocationDomain_5144fcf4-e50c-45cd-b7d0-df1a22f0c22f_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BalanceSheetLocationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_BalanceSheetLocationAxis_5144fcf4-e50c-45cd-b7d0-df1a22f0c22f" xlink:to="loc_us-gaap_BalanceSheetLocationDomain_5144fcf4-e50c-45cd-b7d0-df1a22f0c22f_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BalanceSheetLocationDomain_cc5568d0-95b9-405a-a16a-6a19f34758f5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BalanceSheetLocationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_BalanceSheetLocationAxis_5144fcf4-e50c-45cd-b7d0-df1a22f0c22f" xlink:to="loc_us-gaap_BalanceSheetLocationDomain_cc5568d0-95b9-405a-a16a-6a19f34758f5" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PrepaidExpensesAndOtherCurrentAssetsMember_3214aed9-0b4a-4948-b0f5-5424b51e6608" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PrepaidExpensesAndOtherCurrentAssetsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_BalanceSheetLocationDomain_cc5568d0-95b9-405a-a16a-6a19f34758f5" xlink:to="loc_us-gaap_PrepaidExpensesAndOtherCurrentAssetsMember_3214aed9-0b4a-4948-b0f5-5424b51e6608" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OtherLiabilitiesMember_ab916170-cb02-4070-a691-a247ad7c0812" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OtherLiabilitiesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_BalanceSheetLocationDomain_cc5568d0-95b9-405a-a16a-6a19f34758f5" xlink:to="loc_us-gaap_OtherLiabilitiesMember_ab916170-cb02-4070-a691-a247ad7c0812" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DerivativeNotionalAmount_6873ba76-9ba7-452b-af81-af8aa58301b5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DerivativeNotionalAmount"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems_153e15cb-cff1-4b54-8d65-c761c9043710" xlink:to="loc_us-gaap_DerivativeNotionalAmount_6873ba76-9ba7-452b-af81-af8aa58301b5" xlink:type="arc" order="0"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/RevenueRevenueDisaggregatedbyTypesandGeographyDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#RevenueRevenueDisaggregatedbyTypesandGeographyDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/RevenueRevenueDisaggregatedbyTypesandGeographyDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DisaggregationOfRevenueLineItems_2ed7b3e7-fce3-4454-9d18-eb052fc7f649" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DisaggregationOfRevenueLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DisaggregationOfRevenueTable_66652c18-2f72-4ab7-8ad3-6ef4b4c13b16" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DisaggregationOfRevenueTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_DisaggregationOfRevenueLineItems_2ed7b3e7-fce3-4454-9d18-eb052fc7f649" xlink:to="loc_us-gaap_DisaggregationOfRevenueTable_66652c18-2f72-4ab7-8ad3-6ef4b4c13b16" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionAxis_229ac8e3-2cd4-4542-afd3-d5927c34ebf6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_DisaggregationOfRevenueTable_66652c18-2f72-4ab7-8ad3-6ef4b4c13b16" xlink:to="loc_us-gaap_GeographicDistributionAxis_229ac8e3-2cd4-4542-afd3-d5927c34ebf6" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionDomain_229ac8e3-2cd4-4542-afd3-d5927c34ebf6_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_GeographicDistributionAxis_229ac8e3-2cd4-4542-afd3-d5927c34ebf6" xlink:to="loc_us-gaap_GeographicDistributionDomain_229ac8e3-2cd4-4542-afd3-d5927c34ebf6_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionDomain_285ac19e-3bd7-421c-af98-a2b66f349c01" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_GeographicDistributionAxis_229ac8e3-2cd4-4542-afd3-d5927c34ebf6" xlink:to="loc_us-gaap_GeographicDistributionDomain_285ac19e-3bd7-421c-af98-a2b66f349c01" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionDomesticMember_2789aad1-e259-498f-ba0b-f5580b176f88" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionDomesticMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_GeographicDistributionDomain_285ac19e-3bd7-421c-af98-a2b66f349c01" xlink:to="loc_us-gaap_GeographicDistributionDomesticMember_2789aad1-e259-498f-ba0b-f5580b176f88" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_GeographicDistributionForeignMember_4e80c81c-258c-4de9-a0e4-6c6ba446edef" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_GeographicDistributionForeignMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_GeographicDistributionDomain_285ac19e-3bd7-421c-af98-a2b66f349c01" xlink:to="loc_us-gaap_GeographicDistributionForeignMember_4e80c81c-258c-4de9-a0e4-6c6ba446edef" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_ProductOrServiceAxis_06bc6288-72c6-47f6-bae3-5706475557ef" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_ProductOrServiceAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_DisaggregationOfRevenueTable_66652c18-2f72-4ab7-8ad3-6ef4b4c13b16" xlink:to="loc_srt_ProductOrServiceAxis_06bc6288-72c6-47f6-bae3-5706475557ef" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_ProductsAndServicesDomain_06bc6288-72c6-47f6-bae3-5706475557ef_default" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_ProductsAndServicesDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_srt_ProductOrServiceAxis_06bc6288-72c6-47f6-bae3-5706475557ef" xlink:to="loc_srt_ProductsAndServicesDomain_06bc6288-72c6-47f6-bae3-5706475557ef_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_ProductsAndServicesDomain_4b45cda3-86da-4160-8eab-830bbf8ade4c" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_ProductsAndServicesDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_srt_ProductOrServiceAxis_06bc6288-72c6-47f6-bae3-5706475557ef" xlink:to="loc_srt_ProductsAndServicesDomain_4b45cda3-86da-4160-8eab-830bbf8ade4c" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_InstrumentsandAccessoriesMember_42ac763d-4080-4a30-879d-e09ddc45080c" xlink:href="isrg-20231231.xsd#isrg_InstrumentsandAccessoriesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_ProductsAndServicesDomain_4b45cda3-86da-4160-8eab-830bbf8ade4c" xlink:to="loc_isrg_InstrumentsandAccessoriesMember_42ac763d-4080-4a30-879d-e09ddc45080c" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_SystemsMember_c6ead8f4-5315-4a8a-97da-79244eea583e" xlink:href="isrg-20231231.xsd#isrg_SystemsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_ProductsAndServicesDomain_4b45cda3-86da-4160-8eab-830bbf8ade4c" xlink:to="loc_isrg_SystemsMember_c6ead8f4-5315-4a8a-97da-79244eea583e" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ServiceMember_265f8fa7-9480-427f-8590-0499b32963f2" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ServiceMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_ProductsAndServicesDomain_4b45cda3-86da-4160-8eab-830bbf8ade4c" xlink:to="loc_us-gaap_ServiceMember_265f8fa7-9480-427f-8590-0499b32963f2" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax_21e7dac7-e7ea-46a8-b708-79d3f41bd55d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_DisaggregationOfRevenueLineItems_2ed7b3e7-fce3-4454-9d18-eb052fc7f649" xlink:to="loc_us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax_21e7dac7-e7ea-46a8-b708-79d3f41bd55d" xlink:type="arc" order="0"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/RevenueAdditionalInformationDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#RevenueAdditionalInformationDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/RevenueAdditionalInformationDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionTable_aad3397d-7c0d-4ab3-bc10-961cd29ec914" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionTable_aad3397d-7c0d-4ab3-bc10-961cd29ec914" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionStartDateAxis_6927acf8-b408-448e-a578-77685b32b714" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionStartDateAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionTable_aad3397d-7c0d-4ab3-bc10-961cd29ec914" xlink:to="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionStartDateAxis_6927acf8-b408-448e-a578-77685b32b714" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligation_9f278f0b-f2fe-4b65-8547-152bbaa2dbdd" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligation"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_RevenueRemainingPerformanceObligation_9f278f0b-f2fe-4b65-8547-152bbaa2dbdd" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligationPercentage_87698fac-319f-4964-8742-6742757a368c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligationPercentage"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_RevenueRemainingPerformanceObligationPercentage_87698fac-319f-4964-8742-6742757a368c" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionPeriod1_a0fc4069-36f0-466c-bcab-6775127976c5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionPeriod1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionPeriod1_a0fc4069-36f0-466c-bcab-6775127976c5" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ContractWithCustomerLiabilityRevenueRecognized_a45e6fdd-4965-4be9-b55f-6ccdc057a3f0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ContractWithCustomerLiabilityRevenueRecognized"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_ContractWithCustomerLiabilityRevenueRecognized_a45e6fdd-4965-4be9-b55f-6ccdc057a3f0" xlink:type="arc" order="3"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/RevenueAdditionalInformationDetails_1" xlink:type="simple" xlink:href="isrg-20231231.xsd#RevenueAdditionalInformationDetails_1"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/RevenueAdditionalInformationDetails_1" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionTable_aad3397d-7c0d-4ab3-bc10-961cd29ec914" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionTable_aad3397d-7c0d-4ab3-bc10-961cd29ec914" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligation_9f278f0b-f2fe-4b65-8547-152bbaa2dbdd" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligation"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_RevenueRemainingPerformanceObligation_9f278f0b-f2fe-4b65-8547-152bbaa2dbdd" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligationPercentage_87698fac-319f-4964-8742-6742757a368c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligationPercentage"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_RevenueRemainingPerformanceObligationPercentage_87698fac-319f-4964-8742-6742757a368c" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionPeriod1_a0fc4069-36f0-466c-bcab-6775127976c5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionPeriod1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionPeriod1_a0fc4069-36f0-466c-bcab-6775127976c5" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ContractWithCustomerLiabilityRevenueRecognized_a45e6fdd-4965-4be9-b55f-6ccdc057a3f0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ContractWithCustomerLiabilityRevenueRecognized"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionLineItems_2328e51e-f4eb-4d45-ae29-375c014a5453" xlink:to="loc_us-gaap_ContractWithCustomerLiabilityRevenueRecognized_a45e6fdd-4965-4be9-b55f-6ccdc057a3f0" xlink:type="arc" order="3"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/RevenueSalestypeandOperatingLeaseRevenueDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#RevenueSalestypeandOperatingLeaseRevenueDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/RevenueSalestypeandOperatingLeaseRevenueDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DeferredRevenueArrangementLineItems_ef8fa4c8-c2e9-4bc6-9e76-8170d928e342" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DeferredRevenueArrangementLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DeferredRevenueArrangementByTypeTable_fcc85559-38db-4801-bb98-c954ee2e81b6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DeferredRevenueArrangementByTypeTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_DeferredRevenueArrangementLineItems_ef8fa4c8-c2e9-4bc6-9e76-8170d928e342" xlink:to="loc_us-gaap_DeferredRevenueArrangementByTypeTable_fcc85559-38db-4801-bb98-c954ee2e81b6" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DeferredRevenueArrangementTypeAxis_b9532020-3cdc-4723-bb85-8d2558545902" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DeferredRevenueArrangementTypeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_DeferredRevenueArrangementByTypeTable_fcc85559-38db-4801-bb98-c954ee2e81b6" xlink:to="loc_us-gaap_DeferredRevenueArrangementTypeAxis_b9532020-3cdc-4723-bb85-8d2558545902" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DeferredRevenueArrangementTypeDomain_b9532020-3cdc-4723-bb85-8d2558545902_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DeferredRevenueArrangementTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_DeferredRevenueArrangementTypeAxis_b9532020-3cdc-4723-bb85-8d2558545902" xlink:to="loc_us-gaap_DeferredRevenueArrangementTypeDomain_b9532020-3cdc-4723-bb85-8d2558545902_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DeferredRevenueArrangementTypeDomain_1ea067ae-9e7f-4fb6-adac-87620c2e8096" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DeferredRevenueArrangementTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_DeferredRevenueArrangementTypeAxis_b9532020-3cdc-4723-bb85-8d2558545902" xlink:to="loc_us-gaap_DeferredRevenueArrangementTypeDomain_1ea067ae-9e7f-4fb6-adac-87620c2e8096" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_VariableLeaseRevenueUsageBasedArrangementsMember_9f57d9a2-e52b-489e-9390-3d051630e6c3" xlink:href="isrg-20231231.xsd#isrg_VariableLeaseRevenueUsageBasedArrangementsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_DeferredRevenueArrangementTypeDomain_1ea067ae-9e7f-4fb6-adac-87620c2e8096" xlink:to="loc_isrg_VariableLeaseRevenueUsageBasedArrangementsMember_9f57d9a2-e52b-489e-9390-3d051630e6c3" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseIncomeComprehensiveIncomeExtensibleList_3e30e3ec-1e46-47af-82e2-f484b7207248" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseIncomeComprehensiveIncomeExtensibleList"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_DeferredRevenueArrangementLineItems_ef8fa4c8-c2e9-4bc6-9e76-8170d928e342" xlink:to="loc_us-gaap_SalesTypeLeaseIncomeComprehensiveIncomeExtensibleList_3e30e3ec-1e46-47af-82e2-f484b7207248" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseLeaseIncome_e3262f04-c63a-4233-8011-ed535266df3e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseLeaseIncome"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_DeferredRevenueArrangementLineItems_ef8fa4c8-c2e9-4bc6-9e76-8170d928e342" xlink:to="loc_us-gaap_SalesTypeLeaseLeaseIncome_e3262f04-c63a-4233-8011-ed535266df3e" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OperatingLeaseIncomeComprehensiveIncomeExtensibleList_ccdf6ef8-81dc-4e62-90fe-6e7893913942" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OperatingLeaseIncomeComprehensiveIncomeExtensibleList"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_DeferredRevenueArrangementLineItems_ef8fa4c8-c2e9-4bc6-9e76-8170d928e342" xlink:to="loc_us-gaap_OperatingLeaseIncomeComprehensiveIncomeExtensibleList_ccdf6ef8-81dc-4e62-90fe-6e7893913942" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OperatingLeaseLeaseIncome_5b2b5703-408b-4332-9297-a768a0e00d80" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OperatingLeaseLeaseIncome"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_DeferredRevenueArrangementLineItems_ef8fa4c8-c2e9-4bc6-9e76-8170d928e342" xlink:to="loc_us-gaap_OperatingLeaseLeaseIncome_5b2b5703-408b-4332-9297-a768a0e00d80" xlink:type="arc" order="3"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/LeasesLeaseReceivablesDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#LeasesLeaseReceivablesDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/LeasesLeaseReceivablesDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CapitalLeasedAssetsLineItems_a6046060-ba2d-4db6-837f-fa6a793eb3f9" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CapitalLeasedAssetsLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfCapitalLeasedAsssetsTable_3a6f3932-9190-43c7-b556-da88c4eb1a2e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfCapitalLeasedAsssetsTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_CapitalLeasedAssetsLineItems_a6046060-ba2d-4db6-837f-fa6a793eb3f9" xlink:to="loc_us-gaap_ScheduleOfCapitalLeasedAsssetsTable_3a6f3932-9190-43c7-b556-da88c4eb1a2e" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BalanceSheetLocationAxis_05931f14-0a80-469e-8bce-9095ad0ef641" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BalanceSheetLocationAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfCapitalLeasedAsssetsTable_3a6f3932-9190-43c7-b556-da88c4eb1a2e" xlink:to="loc_us-gaap_BalanceSheetLocationAxis_05931f14-0a80-469e-8bce-9095ad0ef641" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BalanceSheetLocationDomain_05931f14-0a80-469e-8bce-9095ad0ef641_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BalanceSheetLocationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_BalanceSheetLocationAxis_05931f14-0a80-469e-8bce-9095ad0ef641" xlink:to="loc_us-gaap_BalanceSheetLocationDomain_05931f14-0a80-469e-8bce-9095ad0ef641_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_BalanceSheetLocationDomain_61780a0c-0af8-4769-9650-b0c96df69983" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_BalanceSheetLocationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_BalanceSheetLocationAxis_05931f14-0a80-469e-8bce-9095ad0ef641" xlink:to="loc_us-gaap_BalanceSheetLocationDomain_61780a0c-0af8-4769-9650-b0c96df69983" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PrepaidExpensesAndOtherCurrentAssetsMember_498be79a-1227-4d0e-8c5e-b64c5ab26af0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PrepaidExpensesAndOtherCurrentAssetsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_BalanceSheetLocationDomain_61780a0c-0af8-4769-9650-b0c96df69983" xlink:to="loc_us-gaap_PrepaidExpensesAndOtherCurrentAssetsMember_498be79a-1227-4d0e-8c5e-b64c5ab26af0" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OtherNoncurrentAssetsMember_79d63560-1070-4eb0-92f3-95db68295d09" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OtherNoncurrentAssetsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_BalanceSheetLocationDomain_61780a0c-0af8-4769-9650-b0c96df69983" xlink:to="loc_us-gaap_OtherNoncurrentAssetsMember_79d63560-1070-4eb0-92f3-95db68295d09" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_SalesTypeLeaseGrossInvestmentInLease_fcf15095-7ca8-4f8f-bf52-79f5a3ad7b91" xlink:href="isrg-20231231.xsd#isrg_SalesTypeLeaseGrossInvestmentInLease"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_CapitalLeasedAssetsLineItems_a6046060-ba2d-4db6-837f-fa6a793eb3f9" xlink:to="loc_isrg_SalesTypeLeaseGrossInvestmentInLease_fcf15095-7ca8-4f8f-bf52-79f5a3ad7b91" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_SalestypeLeaseDeferredSellingProfit_bdb3f73e-11df-4b06-a27a-c7bf30f961f4" xlink:href="isrg-20231231.xsd#isrg_SalestypeLeaseDeferredSellingProfit"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_CapitalLeasedAssetsLineItems_a6046060-ba2d-4db6-837f-fa6a793eb3f9" xlink:to="loc_isrg_SalestypeLeaseDeferredSellingProfit_bdb3f73e-11df-4b06-a27a-c7bf30f961f4" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLease_a8b685a3-636e-430b-bce0-5b1f82d5067d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLease"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_CapitalLeasedAssetsLineItems_a6046060-ba2d-4db6-837f-fa6a793eb3f9" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLease_a8b685a3-636e-430b-bce0-5b1f82d5067d" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseAllowanceForCreditLoss_0e06b11f-255f-4c22-ab6f-741ab038a16b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseNetInvestmentInLeaseAllowanceForCreditLoss"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_CapitalLeasedAssetsLineItems_a6046060-ba2d-4db6-837f-fa6a793eb3f9" xlink:to="loc_us-gaap_SalesTypeLeaseNetInvestmentInLeaseAllowanceForCreditLoss_0e06b11f-255f-4c22-ab6f-741ab038a16b" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseLeaseReceivable_85dc32a8-e270-418e-9b61-a7915aea4ddd" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseLeaseReceivable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_CapitalLeasedAssetsLineItems_a6046060-ba2d-4db6-837f-fa6a793eb3f9" xlink:to="loc_us-gaap_SalesTypeLeaseLeaseReceivable_85dc32a8-e270-418e-9b61-a7915aea4ddd" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CapitalLeasesNetInvestmentInSalesTypeLeasesAbstract_8bae90dc-42ed-41bc-9cbb-80c5e960dc39" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CapitalLeasesNetInvestmentInSalesTypeLeasesAbstract"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_CapitalLeasedAssetsLineItems_a6046060-ba2d-4db6-837f-fa6a793eb3f9" xlink:to="loc_us-gaap_CapitalLeasesNetInvestmentInSalesTypeLeasesAbstract_8bae90dc-42ed-41bc-9cbb-80c5e960dc39" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesTypeLeaseLeaseReceivable_ec446178-a31d-433e-82e4-6aecf602eb25" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesTypeLeaseLeaseReceivable"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/GoodwillandIntangibleAssetsScheduleofIntangibleAssetsDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#GoodwillandIntangibleAssetsScheduleofIntangibleAssetsDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/GoodwillandIntangibleAssetsScheduleofIntangibleAssetsDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FiniteLivedIntangibleAssetsLineItems_b832e39a-04b0-4878-a0c9-fbee80f89a7f" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FiniteLivedIntangibleAssetsLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable_db7150e6-5149-41ee-95d9-daac765a1012" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_FiniteLivedIntangibleAssetsLineItems_b832e39a-04b0-4878-a0c9-fbee80f89a7f" xlink:to="loc_us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable_db7150e6-5149-41ee-95d9-daac765a1012" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis_6fed41b0-0b22-4f58-9d4b-b081c19be59c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable_db7150e6-5149-41ee-95d9-daac765a1012" xlink:to="loc_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis_6fed41b0-0b22-4f58-9d4b-b081c19be59c" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_6fed41b0-0b22-4f58-9d4b-b081c19be59c_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis_6fed41b0-0b22-4f58-9d4b-b081c19be59c" xlink:to="loc_us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_6fed41b0-0b22-4f58-9d4b-b081c19be59c_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_41f736ce-55c6-409e-9c98-df3a3f169ba6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis_6fed41b0-0b22-4f58-9d4b-b081c19be59c" xlink:to="loc_us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_41f736ce-55c6-409e-9c98-df3a3f169ba6" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_TechnologyBasedIntangibleAssetsMember_81fa5870-ed1b-40b1-9721-702a384ec1d1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_TechnologyBasedIntangibleAssetsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_41f736ce-55c6-409e-9c98-df3a3f169ba6" xlink:to="loc_us-gaap_TechnologyBasedIntangibleAssetsMember_81fa5870-ed1b-40b1-9721-702a384ec1d1" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DistributionRightsMember_36d225aa-aa01-4ba6-bf76-9927ec327a1d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DistributionRightsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_41f736ce-55c6-409e-9c98-df3a3f169ba6" xlink:to="loc_us-gaap_DistributionRightsMember_36d225aa-aa01-4ba6-bf76-9927ec327a1d" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CustomerRelationshipsMember_192136b3-1e92-4c7e-a479-2666657a76e8" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CustomerRelationshipsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_41f736ce-55c6-409e-9c98-df3a3f169ba6" xlink:to="loc_us-gaap_CustomerRelationshipsMember_192136b3-1e92-4c7e-a479-2666657a76e8" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FiniteLivedIntangibleAssetsGross_28ca2fa9-d488-4ec2-806d-f42bfb659879" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FiniteLivedIntangibleAssetsGross"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FiniteLivedIntangibleAssetsLineItems_b832e39a-04b0-4878-a0c9-fbee80f89a7f" xlink:to="loc_us-gaap_FiniteLivedIntangibleAssetsGross_28ca2fa9-d488-4ec2-806d-f42bfb659879" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization_65c6d6b1-8cc5-489d-be1b-4b49175a8e16" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FiniteLivedIntangibleAssetsLineItems_b832e39a-04b0-4878-a0c9-fbee80f89a7f" xlink:to="loc_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization_65c6d6b1-8cc5-489d-be1b-4b49175a8e16" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_FiniteLivedIntangibleAssetsNet_9ebd507b-7c1f-4918-929a-4bc60acf3c38" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_FiniteLivedIntangibleAssetsNet"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_FiniteLivedIntangibleAssetsLineItems_b832e39a-04b0-4878-a0c9-fbee80f89a7f" xlink:to="loc_us-gaap_FiniteLivedIntangibleAssetsNet_9ebd507b-7c1f-4918-929a-4bc60acf3c38" xlink:type="arc" order="2"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/CommitmentsandContingenciesDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#CommitmentsandContingenciesDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/CommitmentsandContingenciesDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LossContingenciesLineItems_7d72256a-013b-4ca5-9621-38886be3df96" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LossContingenciesLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LossContingenciesTable_38f73e50-ea7e-4739-8456-8ad6fb38363c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LossContingenciesTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_LossContingenciesLineItems_7d72256a-013b-4ca5-9621-38886be3df96" xlink:to="loc_us-gaap_LossContingenciesTable_38f73e50-ea7e-4739-8456-8ad6fb38363c" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_LitigationCaseAxis_7c218366-58c9-4663-b58a-4966d4e13a0b" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_LitigationCaseAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_LossContingenciesTable_38f73e50-ea7e-4739-8456-8ad6fb38363c" xlink:to="loc_srt_LitigationCaseAxis_7c218366-58c9-4663-b58a-4966d4e13a0b" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_LitigationCaseTypeDomain_7c218366-58c9-4663-b58a-4966d4e13a0b_default" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_LitigationCaseTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_srt_LitigationCaseAxis_7c218366-58c9-4663-b58a-4966d4e13a0b" xlink:to="loc_srt_LitigationCaseTypeDomain_7c218366-58c9-4663-b58a-4966d4e13a0b_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_LitigationCaseTypeDomain_b2d32654-2c5b-456b-8514-0cdecaa78481" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_LitigationCaseTypeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_srt_LitigationCaseAxis_7c218366-58c9-4663-b58a-4966d4e13a0b" xlink:to="loc_srt_LitigationCaseTypeDomain_b2d32654-2c5b-456b-8514-0cdecaa78481" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RexMedicalLPMember_7e02605f-d457-4e38-9dea-c4db4390d4d6" xlink:href="isrg-20231231.xsd#isrg_RexMedicalLPMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_LitigationCaseTypeDomain_b2d32654-2c5b-456b-8514-0cdecaa78481" xlink:to="loc_isrg_RexMedicalLPMember_7e02605f-d457-4e38-9dea-c4db4390d4d6" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PurchaseCommitmentRemainingMinimumAmountCommitted_2590ea7b-dc1f-4419-9a99-c5308e3405c2" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PurchaseCommitmentRemainingMinimumAmountCommitted"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_LossContingenciesLineItems_7d72256a-013b-4ca5-9621-38886be3df96" xlink:to="loc_us-gaap_PurchaseCommitmentRemainingMinimumAmountCommitted_2590ea7b-dc1f-4419-9a99-c5308e3405c2" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LitigationSettlementExpense_04b1b2d8-225a-46ff-a9c1-3e374b08915d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LitigationSettlementExpense"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_LossContingenciesLineItems_7d72256a-013b-4ca5-9621-38886be3df96" xlink:to="loc_us-gaap_LitigationSettlementExpense_04b1b2d8-225a-46ff-a9c1-3e374b08915d" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LossContingencyDamagesAwardedValue_46d33072-abd8-436a-8da8-69b021cee2e0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LossContingencyDamagesAwardedValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_LossContingenciesLineItems_7d72256a-013b-4ca5-9621-38886be3df96" xlink:to="loc_us-gaap_LossContingencyDamagesAwardedValue_46d33072-abd8-436a-8da8-69b021cee2e0" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LossContingencyNewClaimsFiledNumber_aef7286f-f76d-4694-8c5b-3aefc504b2c3" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LossContingencyNewClaimsFiledNumber"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_LossContingenciesLineItems_7d72256a-013b-4ca5-9621-38886be3df96" xlink:to="loc_us-gaap_LossContingencyNewClaimsFiledNumber_aef7286f-f76d-4694-8c5b-3aefc504b2c3" xlink:type="arc" order="3"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/StockholdersEquityAdditionalInformationDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#StockholdersEquityAdditionalInformationDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/StockholdersEquityAdditionalInformationDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityClassOfTreasuryStockLineItems_b55fdf59-6473-4ea2-a714-95c5fe414e4d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityClassOfTreasuryStockLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ClassOfTreasuryStockTable_643b75f6-4428-45bb-9c1a-5f84d80889c6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ClassOfTreasuryStockTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_b55fdf59-6473-4ea2-a714-95c5fe414e4d" xlink:to="loc_us-gaap_ClassOfTreasuryStockTable_643b75f6-4428-45bb-9c1a-5f84d80889c6" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StatementEquityComponentsAxis_57e6ba4b-df2d-4f0a-9b34-83c6984412c2" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StatementEquityComponentsAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ClassOfTreasuryStockTable_643b75f6-4428-45bb-9c1a-5f84d80889c6" xlink:to="loc_us-gaap_StatementEquityComponentsAxis_57e6ba4b-df2d-4f0a-9b34-83c6984412c2" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityComponentDomain_57e6ba4b-df2d-4f0a-9b34-83c6984412c2_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityComponentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_StatementEquityComponentsAxis_57e6ba4b-df2d-4f0a-9b34-83c6984412c2" xlink:to="loc_us-gaap_EquityComponentDomain_57e6ba4b-df2d-4f0a-9b34-83c6984412c2_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityComponentDomain_c2d95f8f-b08d-4fad-9efb-1585f5ad5165" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityComponentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_StatementEquityComponentsAxis_57e6ba4b-df2d-4f0a-9b34-83c6984412c2" xlink:to="loc_us-gaap_EquityComponentDomain_c2d95f8f-b08d-4fad-9efb-1585f5ad5165" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CommonStockMember_df1c15b3-ac1d-4cb1-835e-1ae657219dc8" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CommonStockMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_c2d95f8f-b08d-4fad-9efb-1585f5ad5165" xlink:to="loc_us-gaap_CommonStockMember_df1c15b3-ac1d-4cb1-835e-1ae657219dc8" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareRepurchaseProgramAxis_a60031fd-7b34-4d0e-9266-debc9429a72d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareRepurchaseProgramAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ClassOfTreasuryStockTable_643b75f6-4428-45bb-9c1a-5f84d80889c6" xlink:to="loc_us-gaap_ShareRepurchaseProgramAxis_a60031fd-7b34-4d0e-9266-debc9429a72d" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareRepurchaseProgramDomain_a60031fd-7b34-4d0e-9266-debc9429a72d_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareRepurchaseProgramDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_ShareRepurchaseProgramAxis_a60031fd-7b34-4d0e-9266-debc9429a72d" xlink:to="loc_us-gaap_ShareRepurchaseProgramDomain_a60031fd-7b34-4d0e-9266-debc9429a72d_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareRepurchaseProgramDomain_b1b948c1-f094-4e57-adf4-197ef0a686b1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareRepurchaseProgramDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_ShareRepurchaseProgramAxis_a60031fd-7b34-4d0e-9266-debc9429a72d" xlink:to="loc_us-gaap_ShareRepurchaseProgramDomain_b1b948c1-f094-4e57-adf4-197ef0a686b1" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_AugustAcceleratedShareRepurchaseProgramMember_1d7593cf-1ffa-4ca8-b4cb-76dc6e1e4146" xlink:href="isrg-20231231.xsd#isrg_AugustAcceleratedShareRepurchaseProgramMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareRepurchaseProgramDomain_b1b948c1-f094-4e57-adf4-197ef0a686b1" xlink:to="loc_isrg_AugustAcceleratedShareRepurchaseProgramMember_1d7593cf-1ffa-4ca8-b4cb-76dc6e1e4146" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_OctoberAcceleratedShareRepurchaseProgramMember_185a761b-ff92-4ac6-9e17-7e5963159368" xlink:href="isrg-20231231.xsd#isrg_OctoberAcceleratedShareRepurchaseProgramMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareRepurchaseProgramDomain_b1b948c1-f094-4e57-adf4-197ef0a686b1" xlink:to="loc_isrg_OctoberAcceleratedShareRepurchaseProgramMember_185a761b-ff92-4ac6-9e17-7e5963159368" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CommonStockRepurchaseProgramMember_a9bfeb4b-a017-465d-a4fa-d534745ffc4d" xlink:href="isrg-20231231.xsd#isrg_CommonStockRepurchaseProgramMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareRepurchaseProgramDomain_b1b948c1-f094-4e57-adf4-197ef0a686b1" xlink:to="loc_isrg_CommonStockRepurchaseProgramMember_a9bfeb4b-a017-465d-a4fa-d534745ffc4d" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockRepurchaseProgramAuthorizedAmount1_6c090731-56f5-4daf-883c-3417f9ddb529" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockRepurchaseProgramAuthorizedAmount1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_b55fdf59-6473-4ea2-a714-95c5fe414e4d" xlink:to="loc_us-gaap_StockRepurchaseProgramAuthorizedAmount1_6c090731-56f5-4daf-883c-3417f9ddb529" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockRepurchaseProgramRemainingAuthorizedRepurchaseAmount1_9e912e64-d0ea-4796-81e8-6e97893bcf16" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockRepurchaseProgramRemainingAuthorizedRepurchaseAmount1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_b55fdf59-6473-4ea2-a714-95c5fe414e4d" xlink:to="loc_us-gaap_StockRepurchaseProgramRemainingAuthorizedRepurchaseAmount1_9e912e64-d0ea-4796-81e8-6e97893bcf16" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodShares_8493bbca-ddbd-47d0-8f5a-7d8a88ebf48e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockRepurchasedAndRetiredDuringPeriodShares"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_b55fdf59-6473-4ea2-a714-95c5fe414e4d" xlink:to="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodShares_8493bbca-ddbd-47d0-8f5a-7d8a88ebf48e" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AcceleratedShareRepurchasesFinalPricePaidPerShare_abde8018-7d57-4604-85a4-1af55a4e8be2" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AcceleratedShareRepurchasesFinalPricePaidPerShare"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_b55fdf59-6473-4ea2-a714-95c5fe414e4d" xlink:to="loc_us-gaap_AcceleratedShareRepurchasesFinalPricePaidPerShare_abde8018-7d57-4604-85a4-1af55a4e8be2" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_AggregateReductionInCommonStockDuringStockRepurchases_25946ac4-e366-452e-a47f-9346a5183d73" xlink:href="isrg-20231231.xsd#isrg_AggregateReductionInCommonStockDuringStockRepurchases"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_b55fdf59-6473-4ea2-a714-95c5fe414e4d" xlink:to="loc_isrg_AggregateReductionInCommonStockDuringStockRepurchases_25946ac4-e366-452e-a47f-9346a5183d73" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_AmountChargedToRetainedEarningsDuringStockRepurchases_14898467-e893-4606-a180-5cb856a21f2d" xlink:href="isrg-20231231.xsd#isrg_AmountChargedToRetainedEarningsDuringStockRepurchases"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_b55fdf59-6473-4ea2-a714-95c5fe414e4d" xlink:to="loc_isrg_AmountChargedToRetainedEarningsDuringStockRepurchases_14898467-e893-4606-a180-5cb856a21f2d" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesAndExciseTaxPayableCurrentAndNoncurrent_bac8b641-bfe9-454a-9a9f-eb0e3d05ee51" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesAndExciseTaxPayableCurrentAndNoncurrent"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_b55fdf59-6473-4ea2-a714-95c5fe414e4d" xlink:to="loc_us-gaap_SalesAndExciseTaxPayableCurrentAndNoncurrent_bac8b641-bfe9-454a-9a9f-eb0e3d05ee51" xlink:type="arc" order="6"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/StockholdersEquityScheduleOfStockRepurchaseActivitiesDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#StockholdersEquityScheduleOfStockRepurchaseActivitiesDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/StockholdersEquityScheduleOfStockRepurchaseActivitiesDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityClassOfTreasuryStockLineItems_2e264683-6fac-4eea-9562-e8cd7c349306" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityClassOfTreasuryStockLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ClassOfTreasuryStockTable_d9a50c9d-7910-4c2d-ac6f-b0fe92188587" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ClassOfTreasuryStockTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_2e264683-6fac-4eea-9562-e8cd7c349306" xlink:to="loc_us-gaap_ClassOfTreasuryStockTable_d9a50c9d-7910-4c2d-ac6f-b0fe92188587" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareRepurchaseProgramAxis_79febc9a-0cc8-4366-8823-0e7ed61a6b1d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareRepurchaseProgramAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ClassOfTreasuryStockTable_d9a50c9d-7910-4c2d-ac6f-b0fe92188587" xlink:to="loc_us-gaap_ShareRepurchaseProgramAxis_79febc9a-0cc8-4366-8823-0e7ed61a6b1d" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareRepurchaseProgramDomain_79febc9a-0cc8-4366-8823-0e7ed61a6b1d_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareRepurchaseProgramDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_ShareRepurchaseProgramAxis_79febc9a-0cc8-4366-8823-0e7ed61a6b1d" xlink:to="loc_us-gaap_ShareRepurchaseProgramDomain_79febc9a-0cc8-4366-8823-0e7ed61a6b1d_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareRepurchaseProgramDomain_6d1a79c0-7e3c-44e6-b70b-0bf43196f830" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareRepurchaseProgramDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_ShareRepurchaseProgramAxis_79febc9a-0cc8-4366-8823-0e7ed61a6b1d" xlink:to="loc_us-gaap_ShareRepurchaseProgramDomain_6d1a79c0-7e3c-44e6-b70b-0bf43196f830" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CommonStockRepurchaseProgramMember_0bf64ca2-3a20-4fa0-bb1f-4c203d0d99c7" xlink:href="isrg-20231231.xsd#isrg_CommonStockRepurchaseProgramMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareRepurchaseProgramDomain_6d1a79c0-7e3c-44e6-b70b-0bf43196f830" xlink:to="loc_isrg_CommonStockRepurchaseProgramMember_0bf64ca2-3a20-4fa0-bb1f-4c203d0d99c7" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StatementEquityComponentsAxis_d8795591-9a87-4b58-b652-fb3fa818703e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StatementEquityComponentsAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ClassOfTreasuryStockTable_d9a50c9d-7910-4c2d-ac6f-b0fe92188587" xlink:to="loc_us-gaap_StatementEquityComponentsAxis_d8795591-9a87-4b58-b652-fb3fa818703e" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityComponentDomain_d8795591-9a87-4b58-b652-fb3fa818703e_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityComponentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_StatementEquityComponentsAxis_d8795591-9a87-4b58-b652-fb3fa818703e" xlink:to="loc_us-gaap_EquityComponentDomain_d8795591-9a87-4b58-b652-fb3fa818703e_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityComponentDomain_40ddc4a7-d66f-4a70-92da-dba52340b8f5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityComponentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_StatementEquityComponentsAxis_d8795591-9a87-4b58-b652-fb3fa818703e" xlink:to="loc_us-gaap_EquityComponentDomain_40ddc4a7-d66f-4a70-92da-dba52340b8f5" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CommonStockMember_33e31e27-df4e-482f-917e-c3ac2ffffddc" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CommonStockMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_40ddc4a7-d66f-4a70-92da-dba52340b8f5" xlink:to="loc_us-gaap_CommonStockMember_33e31e27-df4e-482f-917e-c3ac2ffffddc" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodShares_ffc263a3-39f8-4ccf-87ab-eb6add2cab6b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockRepurchasedAndRetiredDuringPeriodShares"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_2e264683-6fac-4eea-9562-e8cd7c349306" xlink:to="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodShares_ffc263a3-39f8-4ccf-87ab-eb6add2cab6b" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_TreasuryStockAcquiredAverageCostPerShare_e6695d90-8adb-4761-b875-c868f5502f47" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_TreasuryStockAcquiredAverageCostPerShare"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_2e264683-6fac-4eea-9562-e8cd7c349306" xlink:to="loc_us-gaap_TreasuryStockAcquiredAverageCostPerShare_e6695d90-8adb-4761-b875-c868f5502f47" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodValue_2e35e15c-0f89-419e-b68e-53d3c427f731" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockRepurchasedAndRetiredDuringPeriodValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityClassOfTreasuryStockLineItems_2e264683-6fac-4eea-9562-e8cd7c349306" xlink:to="loc_us-gaap_StockRepurchasedAndRetiredDuringPeriodValue_2e35e15c-0f89-419e-b68e-53d3c427f731" xlink:type="arc" order="2"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/StockholdersEquityComponentsofAccumulatedOtherComprehensiveIncomeNetofTaxDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#StockholdersEquityComponentsofAccumulatedOtherComprehensiveIncomeNetofTaxDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/StockholdersEquityComponentsofAccumulatedOtherComprehensiveIncomeNetofTaxDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AccumulatedOtherComprehensiveIncomeLossLineItems_5152c25c-1e28-4850-a7b5-9acdb1af9535" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AccumulatedOtherComprehensiveIncomeLossLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AccumulatedOtherComprehensiveIncomeLossTable_904cbfb1-89dd-45b2-ba08-296d92565fad" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AccumulatedOtherComprehensiveIncomeLossTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_AccumulatedOtherComprehensiveIncomeLossLineItems_5152c25c-1e28-4850-a7b5-9acdb1af9535" xlink:to="loc_us-gaap_AccumulatedOtherComprehensiveIncomeLossTable_904cbfb1-89dd-45b2-ba08-296d92565fad" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StatementEquityComponentsAxis_f3156a74-fcda-4efb-9204-b202f776bf22" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StatementEquityComponentsAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_AccumulatedOtherComprehensiveIncomeLossTable_904cbfb1-89dd-45b2-ba08-296d92565fad" xlink:to="loc_us-gaap_StatementEquityComponentsAxis_f3156a74-fcda-4efb-9204-b202f776bf22" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityComponentDomain_f3156a74-fcda-4efb-9204-b202f776bf22_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityComponentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_StatementEquityComponentsAxis_f3156a74-fcda-4efb-9204-b202f776bf22" xlink:to="loc_us-gaap_EquityComponentDomain_f3156a74-fcda-4efb-9204-b202f776bf22_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EquityComponentDomain_49fd301d-c7a4-4b44-b61d-94b91d756577" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EquityComponentDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_StatementEquityComponentsAxis_f3156a74-fcda-4efb-9204-b202f776bf22" xlink:to="loc_us-gaap_EquityComponentDomain_49fd301d-c7a4-4b44-b61d-94b91d756577" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AccumulatedNetGainLossFromDesignatedOrQualifyingCashFlowHedgesMember_67c17bcc-4bec-41d5-af6f-3f41768e100c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AccumulatedNetGainLossFromDesignatedOrQualifyingCashFlowHedgesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_49fd301d-c7a4-4b44-b61d-94b91d756577" xlink:to="loc_us-gaap_AccumulatedNetGainLossFromDesignatedOrQualifyingCashFlowHedgesMember_67c17bcc-4bec-41d5-af6f-3f41768e100c" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AccumulatedNetUnrealizedInvestmentGainLossMember_3c0df9e2-37bc-4c55-9a88-f22e7da38e70" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AccumulatedNetUnrealizedInvestmentGainLossMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_49fd301d-c7a4-4b44-b61d-94b91d756577" xlink:to="loc_us-gaap_AccumulatedNetUnrealizedInvestmentGainLossMember_3c0df9e2-37bc-4c55-9a88-f22e7da38e70" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AccumulatedTranslationAdjustmentMember_a38b213f-7171-4aad-851a-65fff04f4465" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AccumulatedTranslationAdjustmentMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_49fd301d-c7a4-4b44-b61d-94b91d756577" xlink:to="loc_us-gaap_AccumulatedTranslationAdjustmentMember_a38b213f-7171-4aad-851a-65fff04f4465" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AccumulatedDefinedBenefitPlansAdjustmentMember_9fb9c623-acbc-4595-8ca9-db4644337d26" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AccumulatedDefinedBenefitPlansAdjustmentMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_49fd301d-c7a4-4b44-b61d-94b91d756577" xlink:to="loc_us-gaap_AccumulatedDefinedBenefitPlansAdjustmentMember_9fb9c623-acbc-4595-8ca9-db4644337d26" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AccumulatedOtherComprehensiveIncomeMember_1672192f-9226-4316-a4a0-ae5c54a840ef" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AccumulatedOtherComprehensiveIncomeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EquityComponentDomain_49fd301d-c7a4-4b44-b61d-94b91d756577" xlink:to="loc_us-gaap_AccumulatedOtherComprehensiveIncomeMember_1672192f-9226-4316-a4a0-ae5c54a840ef" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AOCIAttributableToParentNetOfTaxRollForward_1ade80b7-9569-43e1-8900-0f22363c6b5b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AOCIAttributableToParentNetOfTaxRollForward"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_AccumulatedOtherComprehensiveIncomeLossLineItems_5152c25c-1e28-4850-a7b5-9acdb1af9535" xlink:to="loc_us-gaap_AOCIAttributableToParentNetOfTaxRollForward_1ade80b7-9569-43e1-8900-0f22363c6b5b" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockholdersEquity_9605e3f1-786a-4891-98e0-6a1b7e5f5b72" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockholdersEquity"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_AOCIAttributableToParentNetOfTaxRollForward_1ade80b7-9569-43e1-8900-0f22363c6b5b" xlink:to="loc_us-gaap_StockholdersEquity_9605e3f1-786a-4891-98e0-6a1b7e5f5b72" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OtherComprehensiveIncomeLossBeforeReclassificationsNetOfTax_747daf44-8ad8-4496-9950-d84b31798df0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OtherComprehensiveIncomeLossBeforeReclassificationsNetOfTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_AOCIAttributableToParentNetOfTaxRollForward_1ade80b7-9569-43e1-8900-0f22363c6b5b" xlink:to="loc_us-gaap_OtherComprehensiveIncomeLossBeforeReclassificationsNetOfTax_747daf44-8ad8-4496-9950-d84b31798df0" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ReclassificationFromAccumulatedOtherComprehensiveIncomeCurrentPeriodNetOfTax_6fdb47f0-cc8d-43a1-af7f-7a3728cb027e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ReclassificationFromAccumulatedOtherComprehensiveIncomeCurrentPeriodNetOfTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_AOCIAttributableToParentNetOfTaxRollForward_1ade80b7-9569-43e1-8900-0f22363c6b5b" xlink:to="loc_us-gaap_ReclassificationFromAccumulatedOtherComprehensiveIncomeCurrentPeriodNetOfTax_6fdb47f0-cc8d-43a1-af7f-7a3728cb027e" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent_aba7724e-3e6a-40c6-9115-46c9b8fa80f5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_AOCIAttributableToParentNetOfTaxRollForward_1ade80b7-9569-43e1-8900-0f22363c6b5b" xlink:to="loc_us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent_aba7724e-3e6a-40c6-9115-46c9b8fa80f5" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockholdersEquity_20cbf276-9f85-48d6-bf51-52ef5fb4fc00" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockholdersEquity"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/ShareBasedCompensationAdditionalInformationDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#ShareBasedCompensationAdditionalInformationDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/ShareBasedCompensationAdditionalInformationDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_9880e709-a5a2-4230-9ac1-f63525714963" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_9880e709-a5a2-4230-9ac1-f63525714963" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PlanNameAxis_675f2a17-44a6-441d-85c6-2fac9ff089f0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PlanNameAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_9880e709-a5a2-4230-9ac1-f63525714963" xlink:to="loc_us-gaap_PlanNameAxis_675f2a17-44a6-441d-85c6-2fac9ff089f0" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PlanNameDomain_675f2a17-44a6-441d-85c6-2fac9ff089f0_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PlanNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_PlanNameAxis_675f2a17-44a6-441d-85c6-2fac9ff089f0" xlink:to="loc_us-gaap_PlanNameDomain_675f2a17-44a6-441d-85c6-2fac9ff089f0_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_PlanNameDomain_fdfeb08e-6481-4314-8e2c-b5af67235d82" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_PlanNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_PlanNameAxis_675f2a17-44a6-441d-85c6-2fac9ff089f0" xlink:to="loc_us-gaap_PlanNameDomain_fdfeb08e-6481-4314-8e2c-b5af67235d82" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_AmendedAndRestatedTwentyTenStockIncentivePlanMember_0c6ac95c-c0a9-477c-8371-73bc456fcd4c" xlink:href="isrg-20231231.xsd#isrg_AmendedAndRestatedTwentyTenStockIncentivePlanMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PlanNameDomain_fdfeb08e-6481-4314-8e2c-b5af67235d82" xlink:to="loc_isrg_AmendedAndRestatedTwentyTenStockIncentivePlanMember_0c6ac95c-c0a9-477c-8371-73bc456fcd4c" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_AmendedAndRestatedTwentyZeroNineStockIncentivePlanMember_da939d5c-ffaa-4cd3-ba76-286529f95982" xlink:href="isrg-20231231.xsd#isrg_AmendedAndRestatedTwentyZeroNineStockIncentivePlanMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PlanNameDomain_fdfeb08e-6481-4314-8e2c-b5af67235d82" xlink:to="loc_isrg_AmendedAndRestatedTwentyZeroNineStockIncentivePlanMember_da939d5c-ffaa-4cd3-ba76-286529f95982" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_TwoThousandNonEmployeeDirectorsStockOptionPlanMember_b3697a03-7756-4e3b-89d0-db7d16379f1e" xlink:href="isrg-20231231.xsd#isrg_TwoThousandNonEmployeeDirectorsStockOptionPlanMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PlanNameDomain_fdfeb08e-6481-4314-8e2c-b5af67235d82" xlink:to="loc_isrg_TwoThousandNonEmployeeDirectorsStockOptionPlanMember_b3697a03-7756-4e3b-89d0-db7d16379f1e" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_TwoThousandEmployeeStockPurchasePlanMember_a0b3a7f9-7d34-464f-b511-454efd142990" xlink:href="isrg-20231231.xsd#isrg_TwoThousandEmployeeStockPurchasePlanMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_PlanNameDomain_fdfeb08e-6481-4314-8e2c-b5af67235d82" xlink:to="loc_isrg_TwoThousandEmployeeStockPurchasePlanMember_a0b3a7f9-7d34-464f-b511-454efd142990" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AwardTypeAxis_d63bf87e-f3df-422a-94bc-9390c78a68a2" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AwardTypeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_9880e709-a5a2-4230-9ac1-f63525714963" xlink:to="loc_us-gaap_AwardTypeAxis_d63bf87e-f3df-422a-94bc-9390c78a68a2" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_d63bf87e-f3df-422a-94bc-9390c78a68a2_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_AwardTypeAxis_d63bf87e-f3df-422a-94bc-9390c78a68a2" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_d63bf87e-f3df-422a-94bc-9390c78a68a2_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_b9b39e71-7401-45b5-af5e-64383b3ff9c9" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_AwardTypeAxis_d63bf87e-f3df-422a-94bc-9390c78a68a2" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_b9b39e71-7401-45b5-af5e-64383b3ff9c9" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RestrictedStockUnitsRSUMember_49decd02-dba4-4fb8-80de-6a7647d0f660" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RestrictedStockUnitsRSUMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_b9b39e71-7401-45b5-af5e-64383b3ff9c9" xlink:to="loc_us-gaap_RestrictedStockUnitsRSUMember_49decd02-dba4-4fb8-80de-6a7647d0f660" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_AnnualGrantOptionsMember_1ddef5cc-0cbd-4024-ab03-6725f1ee2183" xlink:href="isrg-20231231.xsd#isrg_AnnualGrantOptionsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_b9b39e71-7401-45b5-af5e-64383b3ff9c9" xlink:to="loc_isrg_AnnualGrantOptionsMember_1ddef5cc-0cbd-4024-ab03-6725f1ee2183" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_NewHireOptionsMember_678187e8-82bf-4b14-aaa7-cbdd65613b8a" xlink:href="isrg-20231231.xsd#isrg_NewHireOptionsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_b9b39e71-7401-45b5-af5e-64383b3ff9c9" xlink:to="loc_isrg_NewHireOptionsMember_678187e8-82bf-4b14-aaa7-cbdd65613b8a" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_InitialGrantOptionsMember_5160146a-7188-4fb8-9c0b-51dfb652604c" xlink:href="isrg-20231231.xsd#isrg_InitialGrantOptionsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_b9b39e71-7401-45b5-af5e-64383b3ff9c9" xlink:to="loc_isrg_InitialGrantOptionsMember_5160146a-7188-4fb8-9c0b-51dfb652604c" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_PerformanceShareUnitsPSUsMember_cb91d824-046a-47f6-b947-332fb3c0a264" xlink:href="isrg-20231231.xsd#isrg_PerformanceShareUnitsPSUsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_b9b39e71-7401-45b5-af5e-64383b3ff9c9" xlink:to="loc_isrg_PerformanceShareUnitsPSUsMember_cb91d824-046a-47f6-b947-332fb3c0a264" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EmployeeStockMember_dcda9fef-6793-45fb-af93-6e4fd246c85c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EmployeeStockMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_b9b39e71-7401-45b5-af5e-64383b3ff9c9" xlink:to="loc_us-gaap_EmployeeStockMember_dcda9fef-6793-45fb-af93-6e4fd246c85c" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_NonvestedStockOptionMember_4cd37679-1141-424b-bb9d-7cb0ca21def7" xlink:href="isrg-20231231.xsd#isrg_NonvestedStockOptionMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_b9b39e71-7401-45b5-af5e-64383b3ff9c9" xlink:to="loc_isrg_NonvestedStockOptionMember_4cd37679-1141-424b-bb9d-7cb0ca21def7" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_TitleOfIndividualAxis_cbd42e9a-8983-46b3-9a56-ba2e925aea1e" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_TitleOfIndividualAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_9880e709-a5a2-4230-9ac1-f63525714963" xlink:to="loc_srt_TitleOfIndividualAxis_cbd42e9a-8983-46b3-9a56-ba2e925aea1e" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_TitleOfIndividualWithRelationshipToEntityDomain_cbd42e9a-8983-46b3-9a56-ba2e925aea1e_default" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_TitleOfIndividualWithRelationshipToEntityDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_srt_TitleOfIndividualAxis_cbd42e9a-8983-46b3-9a56-ba2e925aea1e" xlink:to="loc_srt_TitleOfIndividualWithRelationshipToEntityDomain_cbd42e9a-8983-46b3-9a56-ba2e925aea1e_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_TitleOfIndividualWithRelationshipToEntityDomain_11f5df24-883c-4960-ac2f-07c54c05a6b8" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_TitleOfIndividualWithRelationshipToEntityDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_srt_TitleOfIndividualAxis_cbd42e9a-8983-46b3-9a56-ba2e925aea1e" xlink:to="loc_srt_TitleOfIndividualWithRelationshipToEntityDomain_11f5df24-883c-4960-ac2f-07c54c05a6b8" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_EmployeeMember_ed8eb10a-d3c5-4b7d-ada3-706ce1a1b466" xlink:href="isrg-20231231.xsd#isrg_EmployeeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_TitleOfIndividualWithRelationshipToEntityDomain_11f5df24-883c-4960-ac2f-07c54c05a6b8" xlink:to="loc_isrg_EmployeeMember_ed8eb10a-d3c5-4b7d-ada3-706ce1a1b466" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_DirectorMember_82f77552-416c-44be-8ea2-d834f590be3e" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_DirectorMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_TitleOfIndividualWithRelationshipToEntityDomain_11f5df24-883c-4960-ac2f-07c54c05a6b8" xlink:to="loc_srt_DirectorMember_82f77552-416c-44be-8ea2-d834f590be3e" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AwardDateAxis_964fdbe0-a684-48a5-8967-80079021cd79" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AwardDateAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_9880e709-a5a2-4230-9ac1-f63525714963" xlink:to="loc_us-gaap_AwardDateAxis_964fdbe0-a684-48a5-8967-80079021cd79" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AwardDateDomain_964fdbe0-a684-48a5-8967-80079021cd79_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AwardDateDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_AwardDateAxis_964fdbe0-a684-48a5-8967-80079021cd79" xlink:to="loc_us-gaap_AwardDateDomain_964fdbe0-a684-48a5-8967-80079021cd79_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AwardDateDomain_fa3967cf-3504-48d6-9540-fa8103693c0c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AwardDateDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_AwardDateAxis_964fdbe0-a684-48a5-8967-80079021cd79" xlink:to="loc_us-gaap_AwardDateDomain_fa3967cf-3504-48d6-9540-fa8103693c0c" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_FebruaryGrantMember_25d0aea9-3a09-4ec8-8a77-cd17380411c7" xlink:href="isrg-20231231.xsd#isrg_FebruaryGrantMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_AwardDateDomain_fa3967cf-3504-48d6-9540-fa8103693c0c" xlink:to="loc_isrg_FebruaryGrantMember_25d0aea9-3a09-4ec8-8a77-cd17380411c7" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_AugustGrantMember_d69e88fb-71cd-4f84-9391-111438430e4b" xlink:href="isrg-20231231.xsd#isrg_AugustGrantMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_AwardDateDomain_fa3967cf-3504-48d6-9540-fa8103693c0c" xlink:to="loc_isrg_AugustGrantMember_d69e88fb-71cd-4f84-9391-111438430e4b" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_VestingAxis_9f4e96fb-c62b-4e11-bee8-8b608138b3ec" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_VestingAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_9880e709-a5a2-4230-9ac1-f63525714963" xlink:to="loc_us-gaap_VestingAxis_9f4e96fb-c62b-4e11-bee8-8b608138b3ec" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_VestingDomain_9f4e96fb-c62b-4e11-bee8-8b608138b3ec_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_VestingDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_VestingAxis_9f4e96fb-c62b-4e11-bee8-8b608138b3ec" xlink:to="loc_us-gaap_VestingDomain_9f4e96fb-c62b-4e11-bee8-8b608138b3ec_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_VestingDomain_b076df47-0322-4c62-859a-73e0f5608844" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_VestingDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_VestingAxis_9f4e96fb-c62b-4e11-bee8-8b608138b3ec" xlink:to="loc_us-gaap_VestingDomain_b076df47-0322-4c62-859a-73e0f5608844" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationAwardTrancheOneMember_c4b183d9-cba2-4cec-b2dc-8f8124d685ac" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationAwardTrancheOneMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_VestingDomain_b076df47-0322-4c62-859a-73e0f5608844" xlink:to="loc_us-gaap_ShareBasedCompensationAwardTrancheOneMember_c4b183d9-cba2-4cec-b2dc-8f8124d685ac" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationAwardTrancheTwoMember_fd2c23f1-bbc7-4816-bf4b-1bcee146831a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationAwardTrancheTwoMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_VestingDomain_b076df47-0322-4c62-859a-73e0f5608844" xlink:to="loc_us-gaap_ShareBasedCompensationAwardTrancheTwoMember_fd2c23f1-bbc7-4816-bf4b-1bcee146831a" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeAxis_23cc2395-60f6-4967-9b05-c09b27989b9e" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_9880e709-a5a2-4230-9ac1-f63525714963" xlink:to="loc_srt_RangeAxis_23cc2395-60f6-4967-9b05-c09b27989b9e" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeMember_23cc2395-60f6-4967-9b05-c09b27989b9e_default" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_srt_RangeAxis_23cc2395-60f6-4967-9b05-c09b27989b9e" xlink:to="loc_srt_RangeMember_23cc2395-60f6-4967-9b05-c09b27989b9e_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_RangeMember_d85c5e59-f21e-4729-9f70-960228babc17" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_RangeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_srt_RangeAxis_23cc2395-60f6-4967-9b05-c09b27989b9e" xlink:to="loc_srt_RangeMember_d85c5e59-f21e-4729-9f70-960228babc17" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_MinimumMember_68ce926d-ec69-4f83-b7c4-8948a590e62f" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_MinimumMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_RangeMember_d85c5e59-f21e-4729-9f70-960228babc17" xlink:to="loc_srt_MinimumMember_68ce926d-ec69-4f83-b7c4-8948a590e62f" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_MaximumMember_5b21701e-73ae-4d89-8c51-450cac7f83bb" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_MaximumMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_RangeMember_d85c5e59-f21e-4729-9f70-960228babc17" xlink:to="loc_srt_MaximumMember_5b21701e-73ae-4d89-8c51-450cac7f83bb" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod_d797e8bc-75bb-48d7-80ee-1f38f96e2fee" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod_d797e8bc-75bb-48d7-80ee-1f38f96e2fee" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized_f6e7de7e-a69c-467b-a74f-7e8182d48503" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized_f6e7de7e-a69c-467b-a74f-7e8182d48503" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CommonStockCapitalSharesReservedForFutureIssuance_859e7394-b5fa-447c-8636-5b077e32d003" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CommonStockCapitalSharesReservedForFutureIssuance"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_CommonStockCapitalSharesReservedForFutureIssuance_859e7394-b5fa-447c-8636-5b077e32d003" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardAwardVestingRightsPercentage_dd1312a2-2425-423a-aa4c-4929c9538c1a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardAwardVestingRightsPercentage"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardAwardVestingRightsPercentage_dd1312a2-2425-423a-aa4c-4929c9538c1a" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1_902944f5-7b0f-44f6-866b-4ae3407b6ab1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1_902944f5-7b0f-44f6-866b-4ae3407b6ab1" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfMilestones_be5f21b9-dfa2-4cf6-8d66-b02774270e70" xlink:href="isrg-20231231.xsd#isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfMilestones"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfMilestones_be5f21b9-dfa2-4cf6-8d66-b02774270e70" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_StockOptionsGrantedInitialVestingPeriod_4513ecf5-1a6a-43f0-9de9-17ce03f08485" xlink:href="isrg-20231231.xsd#isrg_StockOptionsGrantedInitialVestingPeriod"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_StockOptionsGrantedInitialVestingPeriod_4513ecf5-1a6a-43f0-9de9-17ce03f08485" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_MinimumHoursEmployedPerWeekToParticipateInEmployeeStockPurchasePlan_22495478-40c3-43be-88fa-d1a8103b1582" xlink:href="isrg-20231231.xsd#isrg_MinimumHoursEmployedPerWeekToParticipateInEmployeeStockPurchasePlan"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_MinimumHoursEmployedPerWeekToParticipateInEmployeeStockPurchasePlan_22495478-40c3-43be-88fa-d1a8103b1582" xlink:type="arc" order="7"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_MinimumMonthsEmployedPerYearToParticipateInEmployeeStockPurchasePlan_558457dd-cd03-4967-b4d1-bcec97d94c59" xlink:href="isrg-20231231.xsd#isrg_MinimumMonthsEmployedPerYearToParticipateInEmployeeStockPurchasePlan"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_MinimumMonthsEmployedPerYearToParticipateInEmployeeStockPurchasePlan_558457dd-cd03-4967-b4d1-bcec97d94c59" xlink:type="arc" order="8"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_MaximumPercentageOfEmployeesOnStockholdersToParticipateInEmployeeStockPurchasePlan_75c65faa-c563-4e43-82b2-afa880de4625" xlink:href="isrg-20231231.xsd#isrg_MaximumPercentageOfEmployeesOnStockholdersToParticipateInEmployeeStockPurchasePlan"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_MaximumPercentageOfEmployeesOnStockholdersToParticipateInEmployeeStockPurchasePlan_75c65faa-c563-4e43-82b2-afa880de4625" xlink:type="arc" order="9"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_MaximumPercentageOfPayrollDeductionUnderEspp_266336a9-e389-4f6b-97f0-2969aa2eb233" xlink:href="isrg-20231231.xsd#isrg_MaximumPercentageOfPayrollDeductionUnderEspp"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_MaximumPercentageOfPayrollDeductionUnderEspp_266336a9-e389-4f6b-97f0-2969aa2eb233" xlink:type="arc" order="10"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_OfferingPeriodEmployeeStockPurchasePlans_0786ae23-ad7c-442c-a162-b52638dfd1c4" xlink:href="isrg-20231231.xsd#isrg_OfferingPeriodEmployeeStockPurchasePlans"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_OfferingPeriodEmployeeStockPurchasePlans_0786ae23-ad7c-442c-a162-b52638dfd1c4" xlink:type="arc" order="11"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_OfferingPeriodNumberofPurchasePeriodsOfferingDividedIntoEmployeeStockPurchasePlans_e317e202-e071-492f-ac82-30f22466bd8c" xlink:href="isrg-20231231.xsd#isrg_OfferingPeriodNumberofPurchasePeriodsOfferingDividedIntoEmployeeStockPurchasePlans"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_OfferingPeriodNumberofPurchasePeriodsOfferingDividedIntoEmployeeStockPurchasePlans_e317e202-e071-492f-ac82-30f22466bd8c" xlink:type="arc" order="12"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_OfferingPeriodPeriodOfferingDividedIntoEmployeeStockPurchasePlans_6f555d7c-8414-477b-a93c-d248afe47fee" xlink:href="isrg-20231231.xsd#isrg_OfferingPeriodPeriodOfferingDividedIntoEmployeeStockPurchasePlans"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_OfferingPeriodPeriodOfferingDividedIntoEmployeeStockPurchasePlans_6f555d7c-8414-477b-a93c-d248afe47fee" xlink:type="arc" order="13"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardDiscountFromMarketPriceOfferingDate_41ac3850-0006-4d09-a424-6d38c88d46c0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardDiscountFromMarketPriceOfferingDate"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardDiscountFromMarketPriceOfferingDate_41ac3850-0006-4d09-a424-6d38c88d46c0" xlink:type="arc" order="14"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardDiscountFromMarketPricePurchaseDate_761a35a4-ef14-4fd9-b5cc-508a184c025b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardDiscountFromMarketPricePurchaseDate"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardDiscountFromMarketPricePurchaseDate_761a35a4-ef14-4fd9-b5cc-508a184c025b" xlink:type="arc" order="15"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_PeriodofLookBackThatCouldCauseOfferingPeriodtoResetEmployeeStockPurchasePlans_d624cd1a-b727-40bf-88dc-c93e7f7ac982" xlink:href="isrg-20231231.xsd#isrg_PeriodofLookBackThatCouldCauseOfferingPeriodtoResetEmployeeStockPurchasePlans"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_PeriodofLookBackThatCouldCauseOfferingPeriodtoResetEmployeeStockPurchasePlans_d624cd1a-b727-40bf-88dc-c93e7f7ac982" xlink:type="arc" order="16"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant_6fae7034-0b19-40cc-bf79-09d3fb86cae5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant_6fae7034-0b19-40cc-bf79-09d3fb86cae5" xlink:type="arc" order="17"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_SharebasedCompensationArrangementbySharebasedPaymentAwardEquityInstrumentsOtherthanOptionsExpectedtoVestNumber_fa648699-2140-4dfc-8d6a-0fca9406440a" xlink:href="isrg-20231231.xsd#isrg_SharebasedCompensationArrangementbySharebasedPaymentAwardEquityInstrumentsOtherthanOptionsExpectedtoVestNumber"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_SharebasedCompensationArrangementbySharebasedPaymentAwardEquityInstrumentsOtherthanOptionsExpectedtoVestNumber_fa648699-2140-4dfc-8d6a-0fca9406440a" xlink:type="arc" order="18"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueOutstanding_17000fb3-eb59-47cd-ad5c-800d540d2608" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueOutstanding"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueOutstanding_17000fb3-eb59-47cd-ad5c-800d540d2608" xlink:type="arc" order="19"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue_fde76a8d-98c3-42df-96c2-d9d75875a642" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue_fde76a8d-98c3-42df-96c2-d9d75875a642" xlink:type="arc" order="20"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue_abb876fc-35dd-462a-9941-6485ce50a0ca" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue_abb876fc-35dd-462a-9941-6485ce50a0ca" xlink:type="arc" order="21"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ProceedsFromIssuanceOfSharesUnderIncentiveAndShareBasedCompensationPlansIncludingStockOptions_18feb4f6-6118-4ab2-a4ff-db007e78972d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ProceedsFromIssuanceOfSharesUnderIncentiveAndShareBasedCompensationPlansIncludingStockOptions"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ProceedsFromIssuanceOfSharesUnderIncentiveAndShareBasedCompensationPlansIncludingStockOptions_18feb4f6-6118-4ab2-a4ff-db007e78972d" xlink:type="arc" order="22"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EmployeeServiceShareBasedCompensationTaxBenefitFromExerciseOfStockOptions_03d70102-8660-4bdb-9aa8-0ffa9cb50d38" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EmployeeServiceShareBasedCompensationTaxBenefitFromExerciseOfStockOptions"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_EmployeeServiceShareBasedCompensationTaxBenefitFromExerciseOfStockOptions_03d70102-8660-4bdb-9aa8-0ffa9cb50d38" xlink:type="arc" order="23"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingNumber_a2452f44-7381-4f6d-9892-a22be3d60b64" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingNumber"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingNumber_a2452f44-7381-4f6d-9892-a22be3d60b64" xlink:type="arc" order="24"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageRemainingContractualTerm1_484c276c-310d-421e-967f-7dd06d7550f1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageRemainingContractualTerm1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageRemainingContractualTerm1_484c276c-310d-421e-967f-7dd06d7550f1" xlink:type="arc" order="25"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestExercisableAggregateIntrinsicValue_9035f650-192c-4365-821f-d9a0beb65332" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestExercisableAggregateIntrinsicValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestExercisableAggregateIntrinsicValue_9035f650-192c-4365-821f-d9a0beb65332" xlink:type="arc" order="26"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageExercisePrice_a390cdb3-391f-44cb-a53a-a7d8a326cbfb" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageExercisePrice"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageExercisePrice_a390cdb3-391f-44cb-a53a-a7d8a326cbfb" xlink:type="arc" order="27"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardActualUnitsEarnedPercentageOfTargetUnits_6f7e1aa6-66fe-4702-87fd-12cd2e0e56c7" xlink:href="isrg-20231231.xsd#isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardActualUnitsEarnedPercentageOfTargetUnits"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardActualUnitsEarnedPercentageOfTargetUnits_6f7e1aa6-66fe-4702-87fd-12cd2e0e56c7" xlink:type="arc" order="28"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans_7af5740b-174b-495b-becf-e70f8755c387" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans_7af5740b-174b-495b-becf-e70f8755c387" xlink:type="arc" order="29"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockIssuedDuringPeriodValueEmployeeStockPurchasePlan_46b1321f-c05b-4c8b-8c24-0ecd46a34491" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockIssuedDuringPeriodValueEmployeeStockPurchasePlan"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_StockIssuedDuringPeriodValueEmployeeStockPurchasePlan_46b1321f-c05b-4c8b-8c24-0ecd46a34491" xlink:type="arc" order="30"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognized_86666e06-6717-4726-8c44-3aa0a2616144" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognized"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognized_86666e06-6717-4726-8c44-3aa0a2616144" xlink:type="arc" order="31"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1_f1f7743b-bd2e-49c4-8749-43199a67834a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_4300277c-7980-4c4d-9bd6-19a7fe5857ff" xlink:to="loc_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1_f1f7743b-bd2e-49c4-8749-43199a67834a" xlink:type="arc" order="32"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/ShareBasedCompensationSummaryofRSUandPSUActivityDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#ShareBasedCompensationSummaryofRSUandPSUActivityDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/ShareBasedCompensationSummaryofRSUandPSUActivityDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_f7a77639-7b98-4fb4-9841-977860b76bfe" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_be8df929-958a-4f32-9c02-17d7f905d652" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_f7a77639-7b98-4fb4-9841-977860b76bfe" xlink:to="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_be8df929-958a-4f32-9c02-17d7f905d652" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AwardTypeAxis_03580cb4-057d-400f-9ab2-34b5825f9626" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AwardTypeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_be8df929-958a-4f32-9c02-17d7f905d652" xlink:to="loc_us-gaap_AwardTypeAxis_03580cb4-057d-400f-9ab2-34b5825f9626" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_03580cb4-057d-400f-9ab2-34b5825f9626_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_AwardTypeAxis_03580cb4-057d-400f-9ab2-34b5825f9626" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_03580cb4-057d-400f-9ab2-34b5825f9626_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_0b28b0bd-36db-4253-8806-1d51d1bd51cd" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_AwardTypeAxis_03580cb4-057d-400f-9ab2-34b5825f9626" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_0b28b0bd-36db-4253-8806-1d51d1bd51cd" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RestrictedStockUnitsRSUMember_830e32d1-2006-4770-a7d8-ef96adb65f6e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RestrictedStockUnitsRSUMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_0b28b0bd-36db-4253-8806-1d51d1bd51cd" xlink:to="loc_us-gaap_RestrictedStockUnitsRSUMember_830e32d1-2006-4770-a7d8-ef96adb65f6e" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_PerformanceShareUnitsPSUsMember_5b3541e5-76c1-489c-b370-f661140f8b50" xlink:href="isrg-20231231.xsd#isrg_PerformanceShareUnitsPSUsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_0b28b0bd-36db-4253-8806-1d51d1bd51cd" xlink:to="loc_isrg_PerformanceShareUnitsPSUsMember_5b3541e5-76c1-489c-b370-f661140f8b50" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward_85cd332f-9855-46a0-9fab-ae8e1233b6b2" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_f7a77639-7b98-4fb4-9841-977860b76bfe" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward_85cd332f-9855-46a0-9fab-ae8e1233b6b2" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_377a9621-a76c-49a9-8e78-e7028197ea51" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward_85cd332f-9855-46a0-9fab-ae8e1233b6b2" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_377a9621-a76c-49a9-8e78-e7028197ea51" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod_e8e34239-fea2-45f6-b52d-4f8b028297e1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward_85cd332f-9855-46a0-9fab-ae8e1233b6b2" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod_e8e34239-fea2-45f6-b52d-4f8b028297e1" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod_ae79ac82-782a-46ad-ab94-0af94243cec0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward_85cd332f-9855-46a0-9fab-ae8e1233b6b2" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod_ae79ac82-782a-46ad-ab94-0af94243cec0" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsPerformanceChange_d2ec3ecf-ee2e-4b89-a75d-029ea44d930d" xlink:href="isrg-20231231.xsd#isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsPerformanceChange"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward_85cd332f-9855-46a0-9fab-ae8e1233b6b2" xlink:to="loc_isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsPerformanceChange_d2ec3ecf-ee2e-4b89-a75d-029ea44d930d" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod_097b768a-8eb4-4f38-9336-c737395a70e8" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward_85cd332f-9855-46a0-9fab-ae8e1233b6b2" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod_097b768a-8eb4-4f38-9336-c737395a70e8" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_6f54fe7b-c953-4cef-975f-8d4a7fa2d67e" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward_11a5bfdb-ec9f-4dcd-8137-1e6d8cddc95c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_f7a77639-7b98-4fb4-9841-977860b76bfe" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward_11a5bfdb-ec9f-4dcd-8137-1e6d8cddc95c" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_6316767d-94c1-4ee3-aff2-46721319565c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward_11a5bfdb-ec9f-4dcd-8137-1e6d8cddc95c" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_6316767d-94c1-4ee3-aff2-46721319565c" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_02872540-818a-46ca-a70d-14657847e4bd" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward_11a5bfdb-ec9f-4dcd-8137-1e6d8cddc95c" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_02872540-818a-46ca-a70d-14657847e4bd" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue_af3da59e-1293-4756-8500-d963fc3ed1ed" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward_11a5bfdb-ec9f-4dcd-8137-1e6d8cddc95c" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue_af3da59e-1293-4756-8500-d963fc3ed1ed" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsPerformanceChangeWeightedAverageGrantDateFairValue_67304f2a-980e-46b2-b88d-143d90f28477" xlink:href="isrg-20231231.xsd#isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsPerformanceChangeWeightedAverageGrantDateFairValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward_11a5bfdb-ec9f-4dcd-8137-1e6d8cddc95c" xlink:to="loc_isrg_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsPerformanceChangeWeightedAverageGrantDateFairValue_67304f2a-980e-46b2-b88d-143d90f28477" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue_6ab6357d-858b-45c5-9893-26dcf13686dd" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward_11a5bfdb-ec9f-4dcd-8137-1e6d8cddc95c" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue_6ab6357d-858b-45c5-9893-26dcf13686dd" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_bbd45829-6595-45c4-8e7b-fca1a0def56c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/ShareBasedCompensationOutstandingandExercisableOptionsRangesDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#ShareBasedCompensationOutstandingandExercisableOptionsRangesDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/ShareBasedCompensationOutstandingandExercisableOptionsRangesDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfShareBasedCompensationSharesAuthorizedUnderStockOptionPlansByExercisePriceRangeTable_5e7ef1b7-e52e-41f8-a716-234e1807ce7a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfShareBasedCompensationSharesAuthorizedUnderStockOptionPlansByExercisePriceRangeTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_ScheduleOfShareBasedCompensationSharesAuthorizedUnderStockOptionPlansByExercisePriceRangeTable_5e7ef1b7-e52e-41f8-a716-234e1807ce7a" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansByExercisePriceRangeAxis_60545a4f-ed92-44c5-8b2a-2dac3cf3fb56" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansByExercisePriceRangeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfShareBasedCompensationSharesAuthorizedUnderStockOptionPlansByExercisePriceRangeTable_5e7ef1b7-e52e-41f8-a716-234e1807ce7a" xlink:to="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansByExercisePriceRangeAxis_60545a4f-ed92-44c5-8b2a-2dac3cf3fb56" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_60545a4f-ed92-44c5-8b2a-2dac3cf3fb56_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansByExercisePriceRangeAxis_60545a4f-ed92-44c5-8b2a-2dac3cf3fb56" xlink:to="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_60545a4f-ed92-44c5-8b2a-2dac3cf3fb56_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansByExercisePriceRangeAxis_60545a4f-ed92-44c5-8b2a-2dac3cf3fb56" xlink:to="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeOneMember_388d7d81-32ec-4a28-8045-4da110f3cf68" xlink:href="isrg-20231231.xsd#isrg_RangeOneMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeOneMember_388d7d81-32ec-4a28-8045-4da110f3cf68" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeTwoMember_581b0a2f-0461-4680-b98e-2c53b1a9d479" xlink:href="isrg-20231231.xsd#isrg_RangeTwoMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeTwoMember_581b0a2f-0461-4680-b98e-2c53b1a9d479" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeThreeMember_b860a02d-f387-4edb-93d7-307ac924c93a" xlink:href="isrg-20231231.xsd#isrg_RangeThreeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeThreeMember_b860a02d-f387-4edb-93d7-307ac924c93a" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeFourMember_1bad5819-33e1-4638-b16f-937d37eb7b9f" xlink:href="isrg-20231231.xsd#isrg_RangeFourMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeFourMember_1bad5819-33e1-4638-b16f-937d37eb7b9f" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeFiveMember_b8e1798d-8dd0-424b-a070-0a666659a8c6" xlink:href="isrg-20231231.xsd#isrg_RangeFiveMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeFiveMember_b8e1798d-8dd0-424b-a070-0a666659a8c6" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeSixMember_ce170815-6ddf-4703-9d6d-10865bace961" xlink:href="isrg-20231231.xsd#isrg_RangeSixMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeSixMember_ce170815-6ddf-4703-9d6d-10865bace961" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeSevenMember_6f63d253-c7f4-4f11-b34a-a23baa7ce339" xlink:href="isrg-20231231.xsd#isrg_RangeSevenMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeSevenMember_6f63d253-c7f4-4f11-b34a-a23baa7ce339" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeEightMember_f326d898-60db-466f-8f38-421b7d64fb94" xlink:href="isrg-20231231.xsd#isrg_RangeEightMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeEightMember_f326d898-60db-466f-8f38-421b7d64fb94" xlink:type="arc" order="7"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeNineMember_b53f1219-7f32-4ff0-81bb-445e4aca95c0" xlink:href="isrg-20231231.xsd#isrg_RangeNineMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeNineMember_b53f1219-7f32-4ff0-81bb-445e4aca95c0" xlink:type="arc" order="8"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RangeTenMember_6d410e33-9b60-486b-9597-af37d453adae" xlink:href="isrg-20231231.xsd#isrg_RangeTenMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeDomain_0eba5eac-8c4c-4305-a350-ac102a038693" xlink:to="loc_isrg_RangeTenMember_6d410e33-9b60-486b-9597-af37d453adae" xlink:type="arc" order="9"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLowerRangeLimit_809d01f6-b2bc-4703-8f57-0902d274fd0c" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLowerRangeLimit"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLowerRangeLimit_809d01f6-b2bc-4703-8f57-0902d274fd0c" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeUpperRangeLimit_ea2ed07d-c97d-402e-9b59-bbeedd27b5a6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeUpperRangeLimit"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeUpperRangeLimit_ea2ed07d-c97d-402e-9b59-bbeedd27b5a6" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeNumberOfOutstandingOptions_d20455c9-37e9-4fa3-a9f5-442a08fc8f21" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeNumberOfOutstandingOptions"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeNumberOfOutstandingOptions_d20455c9-37e9-4fa3-a9f5-442a08fc8f21" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeOutstandingOptionsWeightedAverageRemainingContractualTerm2_1ec84832-388d-470e-b51c-05d667938547" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeOutstandingOptionsWeightedAverageRemainingContractualTerm2"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeOutstandingOptionsWeightedAverageRemainingContractualTerm2_1ec84832-388d-470e-b51c-05d667938547" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeOutstandingOptionsWeightedAverageExercisePriceBeginningBalance1_ff980d5f-0ea8-489e-b9f8-063147f21588" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeOutstandingOptionsWeightedAverageExercisePriceBeginningBalance1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeOutstandingOptionsWeightedAverageExercisePriceBeginningBalance1_ff980d5f-0ea8-489e-b9f8-063147f21588" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue_06582274-bfd0-4b6b-abe3-8c0e14f96338" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue_06582274-bfd0-4b6b-abe3-8c0e14f96338" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeNumberOfExercisableOptions_0141d5dd-7f70-4de5-987f-98ac0762a231" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeNumberOfExercisableOptions"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeNumberOfExercisableOptions_0141d5dd-7f70-4de5-987f-98ac0762a231" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1_c40f1593-2594-47f7-b090-377a74c0f170" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1_c40f1593-2594-47f7-b090-377a74c0f170" xlink:type="arc" order="7"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeExercisableOptionsWeightedAverageExercisePrice1_b2639559-e475-4716-b554-583163a7958f" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeExercisableOptionsWeightedAverageExercisePrice1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeExercisableOptionsWeightedAverageExercisePrice1_b2639559-e475-4716-b554-583163a7958f" xlink:type="arc" order="8"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1_c6e1ce46-b579-48c1-8187-64d7a9956390" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1_c6e1ce46-b579-48c1-8187-64d7a9956390" xlink:type="arc" order="9"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharePrice_82ab685f-4145-47d0-bac1-92d0a91b1f1a" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharePrice"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeLineItems_cc3f5ad3-073c-42ed-a597-8e8e4fc69946" xlink:to="loc_us-gaap_SharePrice_82ab685f-4145-47d0-bac1-92d0a91b1f1a" xlink:type="arc" order="10"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/ShareBasedCompensationShareBasedCompensationExpenseDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#ShareBasedCompensationShareBasedCompensationExpenseDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/ShareBasedCompensationShareBasedCompensationExpenseDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems_3d2fab38-1dce-433a-9d2e-27ec0dc6224b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable_944f4958-0ac2-4f12-b859-1b526aab42fa" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems_3d2fab38-1dce-433a-9d2e-27ec0dc6224b" xlink:to="loc_us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable_944f4958-0ac2-4f12-b859-1b526aab42fa" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CostOfSalesProductsAxis_424ef660-59f3-4153-97bd-fbc0bf9c76f0" xlink:href="isrg-20231231.xsd#isrg_CostOfSalesProductsAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable_944f4958-0ac2-4f12-b859-1b526aab42fa" xlink:to="loc_isrg_CostOfSalesProductsAxis_424ef660-59f3-4153-97bd-fbc0bf9c76f0" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CostOfSalesProductsDomain_424ef660-59f3-4153-97bd-fbc0bf9c76f0_default" xlink:href="isrg-20231231.xsd#isrg_CostOfSalesProductsDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_isrg_CostOfSalesProductsAxis_424ef660-59f3-4153-97bd-fbc0bf9c76f0" xlink:to="loc_isrg_CostOfSalesProductsDomain_424ef660-59f3-4153-97bd-fbc0bf9c76f0_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CostOfSalesProductsDomain_f6efdd8c-e1af-47fb-97e8-73efbaef64f3" xlink:href="isrg-20231231.xsd#isrg_CostOfSalesProductsDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_isrg_CostOfSalesProductsAxis_424ef660-59f3-4153-97bd-fbc0bf9c76f0" xlink:to="loc_isrg_CostOfSalesProductsDomain_f6efdd8c-e1af-47fb-97e8-73efbaef64f3" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CostOfSalesProductsBeforeCapitalizationMember_e04d7f49-80a7-4929-b986-c02ba523d306" xlink:href="isrg-20231231.xsd#isrg_CostOfSalesProductsBeforeCapitalizationMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_CostOfSalesProductsDomain_f6efdd8c-e1af-47fb-97e8-73efbaef64f3" xlink:to="loc_isrg_CostOfSalesProductsBeforeCapitalizationMember_e04d7f49-80a7-4929-b986-c02ba523d306" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CapitalizedIntoInventoryMember_c3de7956-ee33-4895-bbe1-3345970d7bb6" xlink:href="isrg-20231231.xsd#isrg_CapitalizedIntoInventoryMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_CostOfSalesProductsDomain_f6efdd8c-e1af-47fb-97e8-73efbaef64f3" xlink:to="loc_isrg_CapitalizedIntoInventoryMember_c3de7956-ee33-4895-bbe1-3345970d7bb6" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_RecognizedInIncomeForAmountsPreviouslyCapitalizedInInventoryMember_60218090-f2ca-4388-9940-56d248cb940e" xlink:href="isrg-20231231.xsd#isrg_RecognizedInIncomeForAmountsPreviouslyCapitalizedInInventoryMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_CostOfSalesProductsDomain_f6efdd8c-e1af-47fb-97e8-73efbaef64f3" xlink:to="loc_isrg_RecognizedInIncomeForAmountsPreviouslyCapitalizedInInventoryMember_60218090-f2ca-4388-9940-56d248cb940e" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeStatementLocationAxis_dc341b1d-d48b-4f19-8d1a-de211506fcf0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeStatementLocationAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable_944f4958-0ac2-4f12-b859-1b526aab42fa" xlink:to="loc_us-gaap_IncomeStatementLocationAxis_dc341b1d-d48b-4f19-8d1a-de211506fcf0" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeStatementLocationDomain_dc341b1d-d48b-4f19-8d1a-de211506fcf0_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeStatementLocationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_IncomeStatementLocationAxis_dc341b1d-d48b-4f19-8d1a-de211506fcf0" xlink:to="loc_us-gaap_IncomeStatementLocationDomain_dc341b1d-d48b-4f19-8d1a-de211506fcf0_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeStatementLocationDomain_3e29c7fa-a8dc-47c0-ae6d-a66b91ffb807" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeStatementLocationDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_IncomeStatementLocationAxis_dc341b1d-d48b-4f19-8d1a-de211506fcf0" xlink:to="loc_us-gaap_IncomeStatementLocationDomain_3e29c7fa-a8dc-47c0-ae6d-a66b91ffb807" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CostOfSalesMember_c1a70317-9a9e-4287-a178-2ecd99a58cb5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CostOfSalesMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeStatementLocationDomain_3e29c7fa-a8dc-47c0-ae6d-a66b91ffb807" xlink:to="loc_us-gaap_CostOfSalesMember_c1a70317-9a9e-4287-a178-2ecd99a58cb5" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_SellingGeneralAndAdministrativeMember_5835dc86-8ce2-47a7-ae8e-facdee1ce102" xlink:href="isrg-20231231.xsd#isrg_SellingGeneralAndAdministrativeMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeStatementLocationDomain_3e29c7fa-a8dc-47c0-ae6d-a66b91ffb807" xlink:to="loc_isrg_SellingGeneralAndAdministrativeMember_5835dc86-8ce2-47a7-ae8e-facdee1ce102" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ResearchAndDevelopmentMember_92d0edb0-6eb7-47d2-84cc-3a84e7722e57" xlink:href="isrg-20231231.xsd#isrg_ResearchAndDevelopmentMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeStatementLocationDomain_3e29c7fa-a8dc-47c0-ae6d-a66b91ffb807" xlink:to="loc_isrg_ResearchAndDevelopmentMember_92d0edb0-6eb7-47d2-84cc-3a84e7722e57" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ConsolidatingReportingAxis_217b1f5e-6472-4909-9b4b-d0e3620ceece" xlink:href="isrg-20231231.xsd#isrg_ConsolidatingReportingAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable_944f4958-0ac2-4f12-b859-1b526aab42fa" xlink:to="loc_isrg_ConsolidatingReportingAxis_217b1f5e-6472-4909-9b4b-d0e3620ceece" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ConsolidatingReportingDomain_217b1f5e-6472-4909-9b4b-d0e3620ceece_default" xlink:href="isrg-20231231.xsd#isrg_ConsolidatingReportingDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_isrg_ConsolidatingReportingAxis_217b1f5e-6472-4909-9b4b-d0e3620ceece" xlink:to="loc_isrg_ConsolidatingReportingDomain_217b1f5e-6472-4909-9b4b-d0e3620ceece_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ConsolidatingReportingDomain_faf0499a-b5e9-4996-af00-a3172785bec7" xlink:href="isrg-20231231.xsd#isrg_ConsolidatingReportingDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_isrg_ConsolidatingReportingAxis_217b1f5e-6472-4909-9b4b-d0e3620ceece" xlink:to="loc_isrg_ConsolidatingReportingDomain_faf0499a-b5e9-4996-af00-a3172785bec7" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CostOfSalesProductMember_ac2a0ee0-f0e3-49bd-acb0-f84340fc101a" xlink:href="isrg-20231231.xsd#isrg_CostOfSalesProductMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_ConsolidatingReportingDomain_faf0499a-b5e9-4996-af00-a3172785bec7" xlink:to="loc_isrg_CostOfSalesProductMember_ac2a0ee0-f0e3-49bd-acb0-f84340fc101a" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_CostOfSalesServiceMember_2e2b91ad-1ff1-406a-9d8b-ede97d44b6f1" xlink:href="isrg-20231231.xsd#isrg_CostOfSalesServiceMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_isrg_ConsolidatingReportingDomain_faf0499a-b5e9-4996-af00-a3172785bec7" xlink:to="loc_isrg_CostOfSalesServiceMember_2e2b91ad-1ff1-406a-9d8b-ede97d44b6f1" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AllocatedShareBasedCompensationExpense_5a8f3018-a036-45e2-9ab5-ae7075d297e0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AllocatedShareBasedCompensationExpense"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems_3d2fab38-1dce-433a-9d2e-27ec0dc6224b" xlink:to="loc_us-gaap_AllocatedShareBasedCompensationExpense_5a8f3018-a036-45e2-9ab5-ae7075d297e0" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EmployeeServiceShareBasedCompensationTaxBenefitFromCompensationExpense_10b3a732-5c22-4702-b5a5-ad0b230db559" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EmployeeServiceShareBasedCompensationTaxBenefitFromCompensationExpense"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems_3d2fab38-1dce-433a-9d2e-27ec0dc6224b" xlink:to="loc_us-gaap_EmployeeServiceShareBasedCompensationTaxBenefitFromCompensationExpense_10b3a732-5c22-4702-b5a5-ad0b230db559" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AllocatedShareBasedCompensationExpenseNetOfTax_da8fa09f-60a5-4674-9ee2-8cc4aa898cf6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AllocatedShareBasedCompensationExpenseNetOfTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems_3d2fab38-1dce-433a-9d2e-27ec0dc6224b" xlink:to="loc_us-gaap_AllocatedShareBasedCompensationExpenseNetOfTax_da8fa09f-60a5-4674-9ee2-8cc4aa898cf6" xlink:type="arc" order="2"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/ShareBasedCompensationWeightedAverageAssumptionsDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#ShareBasedCompensationWeightedAverageAssumptionsDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/ShareBasedCompensationWeightedAverageAssumptionsDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_d77d76e2-5f09-4903-8cdc-a14b5b49ed43" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_b1b45e84-3bfb-4daf-ba1b-257501cb1955" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_d77d76e2-5f09-4903-8cdc-a14b5b49ed43" xlink:to="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_b1b45e84-3bfb-4daf-ba1b-257501cb1955" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AwardTypeAxis_928aa63e-8c28-4ae5-8082-a863127d6270" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AwardTypeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_b1b45e84-3bfb-4daf-ba1b-257501cb1955" xlink:to="loc_us-gaap_AwardTypeAxis_928aa63e-8c28-4ae5-8082-a863127d6270" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_928aa63e-8c28-4ae5-8082-a863127d6270_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_AwardTypeAxis_928aa63e-8c28-4ae5-8082-a863127d6270" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_928aa63e-8c28-4ae5-8082-a863127d6270_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_d32d096f-41d0-46a7-9d5d-9fc2bee3d116" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_AwardTypeAxis_928aa63e-8c28-4ae5-8082-a863127d6270" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_d32d096f-41d0-46a7-9d5d-9fc2bee3d116" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RestrictedStockUnitsRSUMember_4fc3fc55-602d-4f2e-99bd-5f23c8e9e6b2" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RestrictedStockUnitsRSUMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_d32d096f-41d0-46a7-9d5d-9fc2bee3d116" xlink:to="loc_us-gaap_RestrictedStockUnitsRSUMember_4fc3fc55-602d-4f2e-99bd-5f23c8e9e6b2" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockOptionMember_bc33f954-dd94-46bb-85b9-88945c132af7" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockOptionMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_d32d096f-41d0-46a7-9d5d-9fc2bee3d116" xlink:to="loc_us-gaap_StockOptionMember_bc33f954-dd94-46bb-85b9-88945c132af7" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_PerformanceShareUnitsPSUsMember_90522acc-efa2-4bdd-9bb2-b24989e12f4a" xlink:href="isrg-20231231.xsd#isrg_PerformanceShareUnitsPSUsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_d32d096f-41d0-46a7-9d5d-9fc2bee3d116" xlink:to="loc_isrg_PerformanceShareUnitsPSUsMember_90522acc-efa2-4bdd-9bb2-b24989e12f4a" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EmployeeStockMember_8a192abf-7725-40b2-9837-e3403507fb47" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EmployeeStockMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_d32d096f-41d0-46a7-9d5d-9fc2bee3d116" xlink:to="loc_us-gaap_EmployeeStockMember_8a192abf-7725-40b2-9837-e3403507fb47" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_7bac80ca-ff9c-4a8a-9d16-c39b376e60a6" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_d77d76e2-5f09-4903-8cdc-a14b5b49ed43" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_7bac80ca-ff9c-4a8a-9d16-c39b376e60a6" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRate_a0894f39-9f79-44a3-a866-d59ccce52603" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRate"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_d77d76e2-5f09-4903-8cdc-a14b5b49ed43" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRate_a0894f39-9f79-44a3-a866-d59ccce52603" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardFairValueAssumptionsExpectedTerm1_5ebb6e77-5f1f-4f60-b884-fdce4dd45b22" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardFairValueAssumptionsExpectedTerm1"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_d77d76e2-5f09-4903-8cdc-a14b5b49ed43" xlink:to="loc_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardFairValueAssumptionsExpectedTerm1_5ebb6e77-5f1f-4f60-b884-fdce4dd45b22" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsWeightedAverageVolatilityRate_2d278a88-a114-4e82-a488-cb597c0d9273" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsWeightedAverageVolatilityRate"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_d77d76e2-5f09-4903-8cdc-a14b5b49ed43" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsWeightedAverageVolatilityRate_2d278a88-a114-4e82-a488-cb597c0d9273" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_c74b8bff-74ad-46f5-a6be-a942cd5ec9f5" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageGrantDateFairValue"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_d77d76e2-5f09-4903-8cdc-a14b5b49ed43" xlink:to="loc_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_c74b8bff-74ad-46f5-a6be-a942cd5ec9f5" xlink:type="arc" order="4"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/IncomeTaxesAdditionalInformationDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#IncomeTaxesAdditionalInformationDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/IncomeTaxesAdditionalInformationDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeTaxContingencyLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeTaxContingencyTable_91bebc21-542a-41bb-be1c-cb04eee639ce" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeTaxContingencyTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_us-gaap_IncomeTaxContingencyTable_91bebc21-542a-41bb-be1c-cb04eee639ce" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeTaxAuthorityNameAxis_b9820da7-ee2e-48ea-8a9d-acd99c8f6467" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeTaxAuthorityNameAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_IncomeTaxContingencyTable_91bebc21-542a-41bb-be1c-cb04eee639ce" xlink:to="loc_us-gaap_IncomeTaxAuthorityNameAxis_b9820da7-ee2e-48ea-8a9d-acd99c8f6467" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeTaxAuthorityNameDomain_b9820da7-ee2e-48ea-8a9d-acd99c8f6467_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeTaxAuthorityNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_IncomeTaxAuthorityNameAxis_b9820da7-ee2e-48ea-8a9d-acd99c8f6467" xlink:to="loc_us-gaap_IncomeTaxAuthorityNameDomain_b9820da7-ee2e-48ea-8a9d-acd99c8f6467_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeTaxAuthorityNameDomain_59bbbb31-f93c-4db1-8c2f-82830a8be707" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeTaxAuthorityNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_IncomeTaxAuthorityNameAxis_b9820da7-ee2e-48ea-8a9d-acd99c8f6467" xlink:to="loc_us-gaap_IncomeTaxAuthorityNameDomain_59bbbb31-f93c-4db1-8c2f-82830a8be707" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_CaliforniaFranchiseTaxBoardMember_0e03d110-53ff-4bbd-a286-ec800d5f728b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_CaliforniaFranchiseTaxBoardMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxAuthorityNameDomain_59bbbb31-f93c-4db1-8c2f-82830a8be707" xlink:to="loc_us-gaap_CaliforniaFranchiseTaxBoardMember_0e03d110-53ff-4bbd-a286-ec800d5f728b" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_TaxCreditCarryforwardAxis_a1386fe3-79b2-4e72-8c9b-412f58230f9d" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_TaxCreditCarryforwardAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_us-gaap_IncomeTaxContingencyTable_91bebc21-542a-41bb-be1c-cb04eee639ce" xlink:to="loc_us-gaap_TaxCreditCarryforwardAxis_a1386fe3-79b2-4e72-8c9b-412f58230f9d" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_TaxCreditCarryforwardNameDomain_a1386fe3-79b2-4e72-8c9b-412f58230f9d_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_TaxCreditCarryforwardNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_TaxCreditCarryforwardAxis_a1386fe3-79b2-4e72-8c9b-412f58230f9d" xlink:to="loc_us-gaap_TaxCreditCarryforwardNameDomain_a1386fe3-79b2-4e72-8c9b-412f58230f9d_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_TaxCreditCarryforwardNameDomain_2fc5bdef-8996-415d-bf47-7ce0ede6b2b1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_TaxCreditCarryforwardNameDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_TaxCreditCarryforwardAxis_a1386fe3-79b2-4e72-8c9b-412f58230f9d" xlink:to="loc_us-gaap_TaxCreditCarryforwardNameDomain_2fc5bdef-8996-415d-bf47-7ce0ede6b2b1" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ResearchTaxCreditCarryforwardStateMember_6ebf6b5f-2781-4bd8-a174-2829766c4400" xlink:href="isrg-20231231.xsd#isrg_ResearchTaxCreditCarryforwardStateMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_TaxCreditCarryforwardNameDomain_2fc5bdef-8996-415d-bf47-7ce0ede6b2b1" xlink:to="loc_isrg_ResearchTaxCreditCarryforwardStateMember_6ebf6b5f-2781-4bd8-a174-2829766c4400" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_ResearchTaxCreditCarryforwardOtherMember_a593aeaf-8c76-42c2-965a-660bcf3f2dbe" xlink:href="isrg-20231231.xsd#isrg_ResearchTaxCreditCarryforwardOtherMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_TaxCreditCarryforwardNameDomain_2fc5bdef-8996-415d-bf47-7ce0ede6b2b1" xlink:to="loc_isrg_ResearchTaxCreditCarryforwardOtherMember_a593aeaf-8c76-42c2-965a-660bcf3f2dbe" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_EffectiveIncomeTaxRateReconciliationSwissTaxExpenseBenefitNetOfValuationAllowance_0e7504e7-a208-435e-99a3-4280047aacb2" xlink:href="isrg-20231231.xsd#isrg_EffectiveIncomeTaxRateReconciliationSwissTaxExpenseBenefitNetOfValuationAllowance"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_isrg_EffectiveIncomeTaxRateReconciliationSwissTaxExpenseBenefitNetOfValuationAllowance_0e7504e7-a208-435e-99a3-4280047aacb2" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_SwissTaxExpenseBenefitValuationAllowance_eb32203e-38bf-47b2-9b0c-7b0085c1f77e" xlink:href="isrg-20231231.xsd#isrg_SwissTaxExpenseBenefitValuationAllowance"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_isrg_SwissTaxExpenseBenefitValuationAllowance_eb32203e-38bf-47b2-9b0c-7b0085c1f77e" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_EffectiveIncomeTaxRateReconciliationForeignTaxReformAmount_f51cdbf6-b044-402b-b0f0-1df9d6f11931" xlink:href="isrg-20231231.xsd#isrg_EffectiveIncomeTaxRateReconciliationForeignTaxReformAmount"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_isrg_EffectiveIncomeTaxRateReconciliationForeignTaxReformAmount_f51cdbf6-b044-402b-b0f0-1df9d6f11931" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_SalesAndExciseTaxPayableCurrentAndNoncurrent_a098e131-b9f7-4e26-9973-64286c876146" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_SalesAndExciseTaxPayableCurrentAndNoncurrent"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_us-gaap_SalesAndExciseTaxPayableCurrentAndNoncurrent_a098e131-b9f7-4e26-9973-64286c876146" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_OperatingLossCarryforwards_bce97e90-281a-426a-bfe1-355f314e1466" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_OperatingLossCarryforwards"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_us-gaap_OperatingLossCarryforwards_bce97e90-281a-426a-bfe1-355f314e1466" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_DeferredTaxAssetsTaxCreditCarryforwardsSwissTaxCredits_a771840f-da92-4260-b605-e6c29d84e23b" xlink:href="isrg-20231231.xsd#isrg_DeferredTaxAssetsTaxCreditCarryforwardsSwissTaxCredits"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_isrg_DeferredTaxAssetsTaxCreditCarryforwardsSwissTaxCredits_a771840f-da92-4260-b605-e6c29d84e23b" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DeferredTaxAssetsTaxCreditCarryforwardsResearch_e598b6a2-9fe6-433d-a80e-ba7dc7672bd8" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DeferredTaxAssetsTaxCreditCarryforwardsResearch"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_us-gaap_DeferredTaxAssetsTaxCreditCarryforwardsResearch_e598b6a2-9fe6-433d-a80e-ba7dc7672bd8" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_DeferredTaxAssetsValuationAllowance_79551c86-aba1-4ce4-ba58-895b7197a128" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_DeferredTaxAssetsValuationAllowance"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_us-gaap_DeferredTaxAssetsValuationAllowance_79551c86-aba1-4ce4-ba58-895b7197a128" xlink:type="arc" order="7"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_UnrecognizedTaxBenefitsInterestOnIncomeTaxesAccrued_d8d5473a-e188-42a4-8bfc-5bf6ac1a7284" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_UnrecognizedTaxBenefitsInterestOnIncomeTaxesAccrued"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_us-gaap_UnrecognizedTaxBenefitsInterestOnIncomeTaxesAccrued_d8d5473a-e188-42a4-8bfc-5bf6ac1a7284" xlink:type="arc" order="8"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_UnrecognizedTaxBenefits_ca91d705-dfdf-4e86-858b-546d39547532" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_UnrecognizedTaxBenefits"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_us-gaap_UnrecognizedTaxBenefits_ca91d705-dfdf-4e86-858b-546d39547532" xlink:type="arc" order="9"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate_b6b207f9-2ed8-4451-95b8-d13c65e27848" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate_b6b207f9-2ed8-4451-95b8-d13c65e27848" xlink:type="arc" order="10"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_UnrecognizedTaxBenefitsIncomeTaxPenaltiesAndInterestAccrued_5608a549-70a4-40b3-b561-b91e2fa837f0" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_UnrecognizedTaxBenefitsIncomeTaxPenaltiesAndInterestAccrued"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeTaxContingencyLineItems_71f4826f-f8ed-43a3-aedf-830d1e3c1a65" xlink:to="loc_us-gaap_UnrecognizedTaxBenefitsIncomeTaxPenaltiesAndInterestAccrued_5608a549-70a4-40b3-b561-b91e2fa837f0" xlink:type="arc" order="11"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://www.intuitivesurgical.com/role/ValuationandQualifyingAccountsDetails" xlink:type="simple" xlink:href="isrg-20231231.xsd#ValuationandQualifyingAccountsDetails"/>
  <link:definitionLink xlink:role="http://www.intuitivesurgical.com/role/ValuationandQualifyingAccountsDetails" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_srt_ValuationAndQualifyingAccountsDisclosureLineItems_908457e0-24d2-42cf-aa2a-946ead8ba42d" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_ValuationAndQualifyingAccountsDisclosureLineItems"/>
    <link:loc xlink:type="locator" xlink:label="loc_srt_ValuationAndQualifyingAccountsDisclosureTable_c6f3b96b-eb01-41b8-ac81-788fe8eae851" xlink:href="https://xbrl.fasb.org/srt/2023/elts/srt-2023.xsd#srt_ValuationAndQualifyingAccountsDisclosureTable"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="loc_srt_ValuationAndQualifyingAccountsDisclosureLineItems_908457e0-24d2-42cf-aa2a-946ead8ba42d" xlink:to="loc_srt_ValuationAndQualifyingAccountsDisclosureTable_c6f3b96b-eb01-41b8-ac81-788fe8eae851" xlink:type="arc" order="1" xbrldt:closed="true" xbrldt:contextElement="segment"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ValuationAllowancesAndReservesTypeAxis_3ad39e03-1e3c-4189-8bd5-9a44d0ce7cfa" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ValuationAllowancesAndReservesTypeAxis"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="loc_srt_ValuationAndQualifyingAccountsDisclosureTable_c6f3b96b-eb01-41b8-ac81-788fe8eae851" xlink:to="loc_us-gaap_ValuationAllowancesAndReservesTypeAxis_3ad39e03-1e3c-4189-8bd5-9a44d0ce7cfa" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ValuationAllowancesAndReservesDomain_3ad39e03-1e3c-4189-8bd5-9a44d0ce7cfa_default" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ValuationAllowancesAndReservesDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="loc_us-gaap_ValuationAllowancesAndReservesTypeAxis_3ad39e03-1e3c-4189-8bd5-9a44d0ce7cfa" xlink:to="loc_us-gaap_ValuationAllowancesAndReservesDomain_3ad39e03-1e3c-4189-8bd5-9a44d0ce7cfa_default" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ValuationAllowancesAndReservesDomain_114faa56-56b6-4091-9895-afa917ea8bec" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ValuationAllowancesAndReservesDomain"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="loc_us-gaap_ValuationAllowancesAndReservesTypeAxis_3ad39e03-1e3c-4189-8bd5-9a44d0ce7cfa" xlink:to="loc_us-gaap_ValuationAllowancesAndReservesDomain_114faa56-56b6-4091-9895-afa917ea8bec" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AllowanceForCreditLossMember_7f23a0d3-bc5c-4a36-94ea-f79d3ba850df" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AllowanceForCreditLossMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ValuationAllowancesAndReservesDomain_114faa56-56b6-4091-9895-afa917ea8bec" xlink:to="loc_us-gaap_AllowanceForCreditLossMember_7f23a0d3-bc5c-4a36-94ea-f79d3ba850df" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_MovementInValuationAllowancesAndReservesRollForward_d82fa42b-8bba-40b3-83f0-e914468d9881" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_MovementInValuationAllowancesAndReservesRollForward"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_srt_ValuationAndQualifyingAccountsDisclosureLineItems_908457e0-24d2-42cf-aa2a-946ead8ba42d" xlink:to="loc_us-gaap_MovementInValuationAllowancesAndReservesRollForward_d82fa42b-8bba-40b3-83f0-e914468d9881" xlink:type="arc" order="0"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ValuationAllowancesAndReservesBalance_55d319ee-4eb7-4481-ae10-f3d8946652e1" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ValuationAllowancesAndReservesBalance"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_MovementInValuationAllowancesAndReservesRollForward_d82fa42b-8bba-40b3-83f0-e914468d9881" xlink:to="loc_us-gaap_ValuationAllowancesAndReservesBalance_55d319ee-4eb7-4481-ae10-f3d8946652e1" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense_90200f56-23ad-43b5-832c-69b2eda89c4b" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_MovementInValuationAllowancesAndReservesRollForward_d82fa42b-8bba-40b3-83f0-e914468d9881" xlink:to="loc_us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense_90200f56-23ad-43b5-832c-69b2eda89c4b" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ValuationAllowancesAndReservesDeductions_b986f649-8782-4f3d-bfd3-49e88f356c46" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ValuationAllowancesAndReservesDeductions"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_MovementInValuationAllowancesAndReservesRollForward_d82fa42b-8bba-40b3-83f0-e914468d9881" xlink:to="loc_us-gaap_ValuationAllowancesAndReservesDeductions_b986f649-8782-4f3d-bfd3-49e88f356c46" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ValuationAllowancesAndReservesBalance_eb7f08bc-7715-4887-a8d5-45f9aa276a94" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ValuationAllowancesAndReservesBalance"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://fasb.org/us-gaap/role/eedm/ExtensibleEnumerationLists" xlink:type="simple" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-roles-2023.xsd#eedm"/>
  <link:definitionLink xlink:role="http://fasb.org/us-gaap/role/eedm/ExtensibleEnumerationLists" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_IncomeStatementAbstract" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_IncomeStatementAbstract"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_IncomeStatementAbstract" xlink:to="loc_us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_AssetsAbstract" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_AssetsAbstract"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_IntangibleAndOtherAssets_ac837359-df6a-4d44-9046-c39328dbe478" xlink:href="isrg-20231231.xsd#isrg_IntangibleAndOtherAssets"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_AssetsAbstract" xlink:to="loc_isrg_IntangibleAndOtherAssets_ac837359-df6a-4d44-9046-c39328dbe478" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LiabilitiesNoncurrentAbstract" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LiabilitiesNoncurrentAbstract"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LiabilitiesOtherThanLongtermDebtNoncurrent" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LiabilitiesOtherThanLongtermDebtNoncurrent"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_LiabilitiesNoncurrentAbstract" xlink:to="loc_us-gaap_LiabilitiesOtherThanLongtermDebtNoncurrent" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_LiabilitiesAbstract" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_LiabilitiesAbstract"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_Liabilities" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_Liabilities"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_LiabilitiesAbstract" xlink:to="loc_us-gaap_Liabilities" xlink:type="arc" order="1"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://xbrl.sec.gov/ecd/role/TradingArrangementsOnly" xlink:type="simple" xlink:href="https://xbrl.sec.gov/ecd/2023/ecd-2023.xsd#TradingArrangmentsOnly"/>
  <link:definitionLink xlink:role="http://xbrl.sec.gov/ecd/role/TradingArrangementsOnly" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_ecd_AllTradingArrangementsMember" xlink:href="https://xbrl.sec.gov/ecd/2023/ecd-2023.xsd#ecd_AllTradingArrangementsMember"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_BobDeSantisTradingArrangementCommonStockMember_66445dc4-dd90-4df2-b7bc-5d61baccd3e9" xlink:href="isrg-20231231.xsd#isrg_BobDeSantisTradingArrangementCommonStockMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_ecd_AllTradingArrangementsMember" xlink:to="loc_isrg_BobDeSantisTradingArrangementCommonStockMember_66445dc4-dd90-4df2-b7bc-5d61baccd3e9" xlink:type="arc" order="1"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_BobDeSantisTradingArrangementStockOptionsMember_8ec54243-cf5b-4532-a4cf-de9786a82f10" xlink:href="isrg-20231231.xsd#isrg_BobDeSantisTradingArrangementStockOptionsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_ecd_AllTradingArrangementsMember" xlink:to="loc_isrg_BobDeSantisTradingArrangementStockOptionsMember_8ec54243-cf5b-4532-a4cf-de9786a82f10" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_FrederikCWidmanTradingArrangementCommonStockMember_6af0bb84-ea63-4f19-a925-a69cbe03d303" xlink:href="isrg-20231231.xsd#isrg_FrederikCWidmanTradingArrangementCommonStockMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_ecd_AllTradingArrangementsMember" xlink:to="loc_isrg_FrederikCWidmanTradingArrangementCommonStockMember_6af0bb84-ea63-4f19-a925-a69cbe03d303" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_FrederikCWidmanTradingArrangementStockOptionsMember_56aa838f-f8a4-4070-9f1d-77d8cb428754" xlink:href="isrg-20231231.xsd#isrg_FrederikCWidmanTradingArrangementStockOptionsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_ecd_AllTradingArrangementsMember" xlink:to="loc_isrg_FrederikCWidmanTradingArrangementStockOptionsMember_56aa838f-f8a4-4070-9f1d-77d8cb428754" xlink:type="arc" order="4"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://xbrl.sec.gov/ecd/AwardTypeOnly" xlink:type="simple" xlink:href="https://xbrl.sec.gov/ecd/2023/ecd-2023.xsd#AwardTypeOnly"/>
  <link:definitionLink xlink:role="http://xbrl.sec.gov/ecd/AwardTypeOnly" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_RestrictedStockUnitsRSUMember" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_RestrictedStockUnitsRSUMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_us-gaap_RestrictedStockUnitsRSUMember" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_AnnualGrantOptionsMember_cd70c40e-a2ed-4979-9134-2aea4f7d7721" xlink:href="isrg-20231231.xsd#isrg_AnnualGrantOptionsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_isrg_AnnualGrantOptionsMember_cd70c40e-a2ed-4979-9134-2aea4f7d7721" xlink:type="arc" order="5"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_NewHireOptionsMember_0f62cb73-2c33-49eb-894e-54596d61a2b4" xlink:href="isrg-20231231.xsd#isrg_NewHireOptionsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_isrg_NewHireOptionsMember_0f62cb73-2c33-49eb-894e-54596d61a2b4" xlink:type="arc" order="6"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_PerformanceShareUnitsPSUsMember_cc20bd0e-8896-4e01-b002-d24ee091e3a2" xlink:href="isrg-20231231.xsd#isrg_PerformanceShareUnitsPSUsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_isrg_PerformanceShareUnitsPSUsMember_cc20bd0e-8896-4e01-b002-d24ee091e3a2" xlink:type="arc" order="7"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_InitialGrantOptionsMember_f91a76cc-f360-45ea-842c-d98356213746" xlink:href="isrg-20231231.xsd#isrg_InitialGrantOptionsMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_isrg_InitialGrantOptionsMember_f91a76cc-f360-45ea-842c-d98356213746" xlink:type="arc" order="8"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_EmployeeStockMember" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_EmployeeStockMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_us-gaap_EmployeeStockMember" xlink:type="arc" order="9"/>
    <link:loc xlink:type="locator" xlink:label="loc_us-gaap_StockOptionMember" xlink:href="https://xbrl.fasb.org/us-gaap/2023/elts/us-gaap-2023.xsd#us-gaap_StockOptionMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_us-gaap_StockOptionMember" xlink:type="arc" order="10"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_NonvestedStockOptionMember_ac0c3348-7662-4f64-a97d-125186f6468f" xlink:href="isrg-20231231.xsd#isrg_NonvestedStockOptionMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_isrg_NonvestedStockOptionMember_ac0c3348-7662-4f64-a97d-125186f6468f" xlink:type="arc" order="11"/>
  </link:definitionLink>
  <link:roleRef roleURI="http://xbrl.sec.gov/ecd/role/IndividualsOnly" xlink:type="simple" xlink:href="https://xbrl.sec.gov/ecd/2023/ecd-2023.xsd#IndividualsOnly"/>
  <link:definitionLink xlink:role="http://xbrl.sec.gov/ecd/role/IndividualsOnly" xlink:type="extended">
    <link:loc xlink:type="locator" xlink:label="loc_ecd_AllIndividualsMember" xlink:href="https://xbrl.sec.gov/ecd/2023/ecd-2023.xsd#ecd_AllIndividualsMember"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_DavidJRosaMember_1366dccd-d895-4a9d-8e0d-8c22045a4dbc" xlink:href="isrg-20231231.xsd#isrg_DavidJRosaMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_ecd_AllIndividualsMember" xlink:to="loc_isrg_DavidJRosaMember_1366dccd-d895-4a9d-8e0d-8c22045a4dbc" xlink:type="arc" order="2"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_MarshallLMohrMember_237c545f-8a92-4efc-964d-1d8ac9e5d499" xlink:href="isrg-20231231.xsd#isrg_MarshallLMohrMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_ecd_AllIndividualsMember" xlink:to="loc_isrg_MarshallLMohrMember_237c545f-8a92-4efc-964d-1d8ac9e5d499" xlink:type="arc" order="3"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_BobDeSantisMember_91b81bd6-c4ae-4ae9-9fdb-1dd3670732b4" xlink:href="isrg-20231231.xsd#isrg_BobDeSantisMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_ecd_AllIndividualsMember" xlink:to="loc_isrg_BobDeSantisMember_91b81bd6-c4ae-4ae9-9fdb-1dd3670732b4" xlink:type="arc" order="4"/>
    <link:loc xlink:type="locator" xlink:label="loc_isrg_FrederikCWidmanMember_9b321a1d-807e-4872-959d-12758168b564" xlink:href="isrg-20231231.xsd#isrg_FrederikCWidmanMember"/>
    <link:definitionArc xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="loc_ecd_AllIndividualsMember" xlink:to="loc_isrg_FrederikCWidmanMember_9b321a1d-807e-4872-959d-12758168b564" xlink:type="arc" order="5"/>
  </link:definitionLink>
</link:linkbase>
