The following table summarizes restructuring, acquisition, and related costs in the accompanying consolidated statements of operations (in thousands):


	Three Months Ended					Nine Months Ended
	September 29,		September 30,			September 29,		September 30,
	2023		2022			2023		2022
2022 restructuring	$	2,450	$	889		$	5,324	$	889
2020 restructuring		1,880		887			2,613		2,119
Total restructuring charges		4,330		1,776			7,937		3,008
Acquisition and related charges		151		(151	)		254		(358	)
Total restructuring, acquisition, and related costs	$	4,481	$	1,625		$	8,191	$	2,650

As a result of the Company’s ongoing evaluations and efforts to reduce its operating costs, while improving efficiency and effectiveness, the Company initiated the 2022 restructuring program in the third quarter of 2022. This program is focused on reducing operating complexity in the Company, including reducing infrastructure costs and streamlining the Company’s operating model to better serve its customers. In addition, the program is focused on cost reduction actions that improve gross margins for the overall company in line with the Company's multi-year gross margin expansion program. During the three and nine months ended September 29, 2023, the Company recorded $2.5 million and $5.3 million, respectively, in severance, facility related, and other charges in connection with the 2022 restructuring program. As of September 29, 2023, the Company had incurred cumulative costs of $6.7 million related to this restructuring plan. The Company anticipates substantially completing the 2022 restructuring program by the end of 2023 and expects to incur additional restructuring charges of $2.5 million to $3.0 million related to the 2022 restructuring program.

The following table summarizes restructuring costs associated with the 2022 restructuring program by reportable segment (in thousands):


	Three Months Ended				Nine Months Ended
	September 29,		September 30,		September 29,		September 30,
	2023		2022		2023		2022
Precision Medicine and Manufacturing	$	76	$	889	$	1,064	$	889
Medical Solutions		253		—		293		—
Robotics and Automation		1,632		—		3,168		—
Unallocated Corporate and Shared Services		489		—		799		—
Total	$	2,450	$	889	$	5,324	$	889

The Company initiated the 2020 restructuring program in the third quarter of 2020. This program is focused on reducing operating complexity in the Company, including reducing infrastructure costs and streamlining the Company’s operating model to better serve its customers. In addition, the program is focused on cost reduction actions that improve gross margins for the overall company. During the three and nine months ended September 29, 2023, the Company recorded $1.9 million and $2.6 million respectively, in severance, facility related, and other costs in connection with the 2020 restructuring program. As of September 29, 2023, the Company had incurred cumulative costs of $16.5 million related to this restructuring plan. The 2020 restructuring program was substantially completed in the third quarter of 2023.

The following table summarizes restructuring costs associated with the 2020 restructuring program by reportable segment (in thousands):


	Three Months Ended				Nine Months Ended
	September 29,		September 30,		September 29,		September 30,
	2023		2022		2023		2022
Precision Medicine and Manufacturing	$	1,543	$	758	$	2,050	$	1,952
Medical Solutions		—		101		—		207
Robotics and Automation		337		22		563		(46	)
Unallocated Corporate and Shared Services		—		6		—		6
Total	$	1,880	$	887	$	2,613	$	2,119

The following table summarizes the accrual activities, by component, related to the Company’s restructuring plans recorded in the accompanying consolidated balance sheets (in thousands):


	Total			Employee Related			Facility Related			Other
Balance at December 31, 2022	$	2,410		$	1,902		$	452		$	56
Restructuring charges		7,937			4,799			1,929			1,209
Cash payments		(5,969	)		(4,803	)		(600	)		(566	)
Non-cash write-offs and other adjustments(1)		(1,346	)		20			(823	)		(543	)
Balance at September 29, 2023	$	3,032		$	1,918		$	958		$	156

(1) Non-cash write-offs and other adjustments included impairment of assets amounting to $1.4 million.

Acquisition costs in connection with business combinations, including finders’ fees, legal, valuation, and other professional or consulting fees, totaled $0.2 million and $0.3 million for the three and nine months ended September 29, 2023, and $0.8 million and $1.1 million for the three and nine months ended September 30, 2022, respectively. During the three and nine months ended September 30, 2022, the Company recognized a reduction of $1.0 million and $1.4 million, respectively, in earn-out expenses related to prior-year acquisitions. The majority of acquisition and related costs for the three and nine months ended September 29, 2023 were included in the Company’s Unallocated Corporate and Shared Services reportable segment. The majority of acquisition and related

costs for the three and nine months ended September 30, 2022 were included in the Company’s Precision Medicine and Manufacturing, Robotics and Automation, and Unallocated Corporate and Shared Services reportable segments.