Forever is a long time. But there are a select few companies that can deliver strong returns to their shareholders over the entire course of their lives. These fortune-builders typically benefit from powerful trends that help to drive their sales and profits consistently higher over time.

To help you in your search for the best long-term investments, here are three elite businesses that are set to generate wealth-building gains for their shareowners for decades to come.

1. Intuitive Surgical

The shift to robot-assisted medical procedures is likely to be one of the most lucrative in all of healthcare. That's great news for Intuitive Surgical (ISRG 0.59%), the global leader in robotic surgery solutions.

Intuitive's da Vinci Surgical System is the gold standard in minimally invasive surgery. The system is designed to enhance a surgeon's capabilities, with 3D high-definition views and precision-boosting tremor-filtration technology. 

Intuitive has already reached critical mass. Hospitals have purchased more than 7,700 da Vinci systems. More than 60,000 surgeons are trained on them. These doctors have conducted more than 12 million surgical procedures with Intuitive's tools. Together, this represents a tremendous level of investment in Inituitive's technology on the part of healthcare facilities around the world.

Yet Intuitive still accounts for only a small portion of the overall surgical market. Healthcare is a massive industry, and Intuitive has plenty of room to expand into new procedures. For a recent example, in April, Intuitive received Food and Drug Administration (FDA) clearance for its da Vinci SP surgical system for simple prostatectomies, a procedure that can help people with enlarged prostates. 

In part because of the benefits robotic surgery can provide -- including less pain for patients during recovery, lower risk of infection, smaller scars, and shorter hospital stays, according to Cleveland Clinic -- investors can expect demand for Intuitive's surgical systems and instruments to grow steadily over time.

2. ExxonMobil

Despite the rapid growth of renewable-energy sources like wind and solar power, fossil fuels still provide more than 80% of global energy consumption, according to the Energy Institute. As a leading producer of oil and gas, ExxonMobil (XOM -2.78%) stands to profit handsomely from the world's persistent need for dependable fuel supplies.

Yet while oil and gas are likely to remain in high demand for the foreseeable future, Exxon is looking even further ahead. The energy leader sees an enormous growth opportunity in low-carbon energy solutions.

Exxon is investing aggressively in carbon capture and storage, a process that can contain more than 90% of emissions from power plants and industrial sites, according to the Center for Climate and Energy Solutions. The oil giant is also building facilities for hydrogen and renewable diesel production.

It's important to note that these are not just environmentally focused endeavors. Exxon expects to generate returns on investment of 10% to 20% for these projects. Moreover, Exxon believes that its annual revenue from low-carbon solutions could eventually reach into the hundreds of billions of dollars, as businesses and governments place a greater emphasis on reducing emissions in the coming decades. 

3. Apple

Apple (AAPL -0.35%) is the epitome of a buy-and-hold stock. The tech titan has successfully navigated -- and often led -- multiple technological shifts, including the development of the personal computer, smartphone, and wearable devices. Now, Apple is making a major push into the rapidly expanding augmented and virtual-reality market, with its new Vision Pro headsets. 

Each new device Apple sells brings another person into its vast ecosystem of products of services. The company has a massive installed base of more than 2 billion devices. Moreover, once someone buys an iPhone, Mac, or other Apple device, that person tends to remain a loyal customer. This situation creates steadily growing demand for the tech juggernaut's ever-expanding array of services, which includes popular offerings, like Apple Pay, iCloud+, and Apple Music.

These dynamics also help Apple produce a staggering amount of profit, including $100 billion in 2022 alone. The tech juggernaut passes much of this cash on to its investors by way of dividends and share repurchases, both of which should help to support a rising stock price in the years ahead.

Unfortunately, many people choose to trade Apple stock based on short-term concerns. Don't make that mistake. Buy and hold this proven winner, and you'll have an excellent shot at building lasting wealth.