General and pelvic endoscopic surgical procedures employ a broad array of endoscopic surgical products, including access needles, trocars, hand-assisted laparoscopic surgery devices, endoscopes, hand instruments, insufflation systems and robotic-surgery systems. The U.S. market for products used in general and pelvic endoscopic surgery totaled more than $3.3 billion in 2008. Over the next five years, this burgeoning market is expected to grow at a healthy 9.0% compound annual rate, approaching $5.2 billion in 2013. Despite the current economic recession, strong pricing pressure and competition, this market is expected to exhibit healthier-than-average growth due to demographics, ongoing demand for less invasive, less-costly surgery, increased surgeon training, and adaption of next-generation endoscopic technologies, including robotic surgical systems and next-generation endoscopic instrumentation. In addition, emerging "scarless" techniques-including reducing the surgical access to a single incision or via natural orifices such as the umbilicus-have resulted in the development of several novel surgical instruments and systems that may significantly impact the field of laparoscopy.
This dynamic report from Medtech Insight includes analyses of products, markets, competitors, and emerging technology and opportunities in the U.S. general and pelvic endoscopic surgery products market. Product areas include: access needles, trocars, hand-assisted laparoscopic surgery devices, single-port access or single-incision laparoscopy systems, incisionless access systems, insufflation systems, endoscopes, hand instruments, endoscopic access site closure products, robotic-assisted minimally invasive surgery systems, and surgical navigation systems.
EXECUTIVE SUMMARY i. Endoscopic Surgery a. Specialty Endoscopic Procedures ii. Endoscopic Surgical Products a. Access Devices b. Access Site Closure Devices c. Endoscopes d. Hand Instruments e. Insufflation Devices f. Robotic-Assisted Minimally Invasive Surgical Systems iii. Emerging Technologies iv. General and Pelvic Endoscopic Surgery Products Market a. Market Analysis and Segment Growth b. Competitive Analysis v. Methodology Exhibit ES-1: Endoscopic Surgery, Procedures Volumes Forecast, 2008-2013 Exhibit ES-2: 2010, Selected Endoscopic Surgery Instrumentation Exhibit ES-3: General and Pelvic Endoscopic Surgery Products, Combined Market Forecast, 2008-2013 Exhibit ES-4: 2008, General and Pelvic Endoscopic Surgery Products Market, Share by Segment Exhibit ES-5: 2013, General and Pelvic Endoscopic Surgery Products Market, Share by Segment Exhibit ES-6: 2009, Combined General and Pelvic Endoscopic Surgery Products Market, Share by Supplier 1. CLINICAL OVERVIEW 1.1 Endoscopic Surgery 1.1.1 Endoscopic Access and a Working Space 1.1.2 Anesthesia 1.1.3 Insufflation 1.1.4 Trocar Insertion 1.1.5 Patient Considerations 1.2 Specialty Procedures 1.3 Advantages, Disadvantages, and Risks 1.3.1 Injuries Associated with Access Needle and Trocar Insertion 1.3.2 Incisional Hernia 1.4 Endoscopic Surgical Products 1.4.1 Access Devices 184.108.40.206 Access Needles 220.127.116.11 Trocars 1.4.2 Access Site Closure Devices 1.4.3 Hand-Assisted Systems 1.4.4 Endoscopes 1.4.5 Endoscopic Video Products 1.4.6 Hand Instruments 18.104.22.168 Clamps and Needle Holders 22.214.171.124 Clip Appliers 126.96.36.199 Forceps 188.8.131.52 Graspers and Retractors 184.108.40.206 Pencils and Dissectors 220.127.116.11 Scissors 18.104.22.168 Staplers 1.4.7 Insufflation Devices 22.214.171.124 Traditional Insufflation 126.96.36.199 Gasless Insufflation 1.4.8 Suction/Irrigation and Fluid Management Systems 1.4.9 Ancillary Devices Used in Endoscopic Surgical Procedures 188.8.131.52 Mechanical Assist Devices 184.108.40.206 Specimen Retrieval Bags 220.127.116.11 Surgical Smoke Evacuation Devices 1.4.10 Surgical Navigation and Robotic Surgical Systems 1.4.11 Emerging Technologies Exhibit 1-1: 2010, Selected Endoscopic Surgery Instrumentation 2. ENDOSCOPIC SURGICAL PROCEDURES 2.1 Adrenalectomy 2.1.1 Instrumentation 2.1.2 Surgical Technique 2.2 Appendectomy 2.2.1 Instrumentation 2.2.2 Surgical Technique 2.3 Burch Colposuspension 2.3.1 Instrumentation 2.3.2 Surgical Technique 2.4 Cholecystectomy 2.4.1 Instrumentation 2.4.2 Surgical Technique 2.5 Colectomy 2.5.1 Instrumentation 2.5.2 Surgical Technique 2.6 Cystectomy 2.6.1 Instrumentation 2.6.2 Surgical Technique 2.7 Falloposcopy 2.7.1 Instrumentation 2.7.2 Surgical Technique 2.8 Fundoplication 2.8.1 Instrumentation 2.8.2 Surgical Technique 2.9 Gastroduodenal Ulcer Repair 2.9.1 Instrumentation 2.9.2 Surgical Technique 2.10 Gastroplasty and Gastric Bypass 2.10.1 Instrumentation 2.10.2 Surgical Technique 18.104.22.168 Vertical Banded Gastroplasty 22.214.171.124 Roux-en-Y Gastric Bypass 126.96.36.199 Adjustable Lap Band Bypass 2.11 Hysterectomy 2.11.1 Instrumentation 2.11.2 Surgical Technique 2.12 Hysteromyomectomy 2.12.1 Instrumentation 2.12.2 Surgical Technique 2.13 Hysteroscopy 2.13.1 Instrumentation 2.13.2 Surgical Technique 188.8.131.52 Cryoablation 184.108.40.206 Endometrial Ablation 2.14 Inguinal Herniorrhaphy 2.14.1 Instrumentation 2.14.2 Surgical Technique 2.15 Nephrectomy 2.15.1 Instrumentation 2.15.2 Surgical Technique 2.16 Oophorectomy 2.16.1 Instrumentation 2.16.2 Surgical Technique 2.17 Pelvic Adhesions 2.17.1 Instrumentation 2.17.2 Surgical Technique 2.18 Renal and Ureteral Calculi Management 2.18.1 Instrumentation 2.18.2 Surgical Technique 2.19 Salpingostomy 2.19.1 Instrumentation 2.19.2 Surgical Technique 2.20 Splenectomy 2.20.1 Instrumentation 2.20.2 Surgical Technique 2.21 Transurethral Resection of the Prostate 2.21.1 Instrumentation 2.21.2 Surgical Technique 2.22 Tubal Ligation 2.22.1 Instrumentation 2.22.2 Surgical Technique 2.23 Urethrotomy 2.23.1 Instrumentation 2.23.2 Surgical Technique 2.24 Procedure Volumes Forecast Exhibit 2-1: Endoscopic Surgery, Procedures Volumes Forecast, 2008-2013 3. ENDOSCOPIC ACCESS DEVICES MARKET 3.1 Single-Incision Laparoscopy 3.1.1 Natural Orifice Translumenal Endoscopic Surgery 3.1.2 Market Analysis 220.127.116.11 Covidien 18.104.22.168 Ethicon Endo-Surgery/Johnson & Johnson 22.214.171.124 Olympus America/Olympus 126.96.36.199 Patient Outcomes 188.8.131.52 Economics 184.108.40.206 Consumer Demand 3.2 Types of Access Devices 3.2.1 Access Needles 220.127.116.11 ConMed EndoSurgery/ConMed 18.104.22.168 Autosuture/Covidien 22.214.171.124 Ethicon Endo-Surgery/Johnson & Johnson 126.96.36.199 Medovations 188.8.131.52 Richard Wolf Medical Instruments/Richard Wolf 184.108.40.206 Market Forecast 220.127.116.11 Competitive Analysis 3.2.2 Trocars and Single-Port Access/Incisionless Access Systems 18.104.22.168 Advanced Surgical Concepts/Olympus America/Olympus 22.214.171.124 Applied Medical Resources 126.96.36.199 Aesculap/B. Braun Melsungen 188.8.131.52 Cardinal Health 184.108.40.206 ConMed EndoSurgery/ConMed 220.127.116.11 Autosuture/Covidien 18.104.22.168 Ethicon Endo-Surgery/Johnson & Johnson 22.214.171.124 Olympus America/Olympus 126.96.36.199 Karl Storz Endoscopy-America/Karl Storz 188.8.131.52 SurgiQuest 184.108.40.206 TransEnterix 220.127.116.11 USGI Medical 18.104.22.168 Richard Wolf Medical Instruments/Richard Wolf 22.214.171.124 Market Forecast-Trocars 126.96.36.199 Competitive Analysis 3.3.3 Hand-Assisted Laparoscopic Surgery Devices 188.8.131.52 Applied Medical Resources 184.108.40.206 Ethicon Endo-Surgery/Johnson & Johnson 220.127.116.11 Market Forecast 18.104.22.168 Competitive Analysis Exhibit 3-1: Selected Advantages of Single-Incision/Single-Port Surgery Exhibit 3-2: Procedures Employing Single-Incision Laparoscopy Exhibit 3-3: Surgical Procedures Being Considered for Single-Incision Laparoscopy, Procedure Volumes Forecast, 2008-2013 Exhibit 3-4: Factors Impacting the Adoption of Single-Incision Laparoscopy Exhibit 3-5: 2010, Selected Access Needles Exhibit 3-6: ConMed EndoSurgery's Insufflation System Exhibit 3-7: Medovations' Hi-Flow Insufflation Needle Exhibit 3-8: Richard Wolf Medical Instruments' Veress Needle Exhibit 3-9: Access Needles, Market Forecast, 2008-2013 Exhibit 3-10: 2009, Access Needles Market, Share by Supplier Exhibit 3-11: 2010, Selected Single-Incision Access Systems Exhibit 3-12: Advanced Surgical Concepts/Olympus' TriPort Multi-Instrument Access Port Exhibit 3-13: Advanced Surgical Concepts/Olympus' QuadPort Multi-Instrument Access Port Exhibit 3-14: Applied Medical Resources' GelPOINT Access Platform Exhibit 3-15: Applied Medical Resources' Premium Disposable Trocar, Kii GelPort Balloon Trocar, and Universal Seal Exhibit 3-16: Applied Medical Resources' Convertible Access System Exhibit 3-17: Applied Medical Resources' Separator Abdominal Access System Exhibit 3-18: Applied Medical Resources' Fios First Entry with Spaceguard Technology Exhibit 3-19: ConMed EndoSurgery's CORE Entree Gold Disposable Trocars and Cannulas Exhibit 3-20: Autosuture's Versaport V2 Conventional Trocar Exhibit 3-21: Autosuture's Versaport Plus Bladeless Trocars Exhibit 3-22: Autosuture's SILS Port Access Device Exhibit 3-23: Ethicon Endo-Surgery's ENDOPATH XCEL Bladeless Trocar Exhibit 3-24: SurgiQuest's AirSeal Dynamic Pressure System Exhibit 3-25: Typical Limitations of Traditional Trocar Valve Technology that are Addressed by the AirSeal Dynamic Pressure System Exhibit 3-26: SurgiQuest's AnchorPort Trocar Exhibit 3-27: TransEnterix's SPIDER Surgical System Exhibit 3-28: USGI Medical's Incisionless Operating Platform Exhibit 3-29: Richard Wolf Medical Instruments' RIWO-ART Reusable Trocars Exhibit 3-30: Trocars, Market Forecast, 2008-2013 Exhibit 3-31: 2009, Trocars Market, Share by Supplier Exhibit 3-32: 2010, Selected Hand-Assisted Laparoscopic Surgery Devices Exhibit 3-33: Applied Medical Resources' GelPort Laparoscopic System Exhibit 3-34: Ethicon Endo-Surgery's LAP DISC Hand Access Device Exhibit 3-35: Ethicon Endo-Surgery's DEXTRUS Minimally Invasive Access System with Finger-Mounted Instruments Exhibit 3-36: Hand-Assisted Laparoscopic Surgery Devices, Market Forecast, 2008-2013 Exhibit 3-37: 2009, Hand-Assisted Laparoscopic Surgery Devices Market, Share by Supplier 4. INSUFFLATION PRODUCTS MARKET 4.1 Products 4.1.1 Aesculap/B. Braun Melsungen 4.1.2 Cardinal Health 4.1.3 LEXION Medical 4.1.4 Olympus America/Olympus 4.1.5 Smith & Nephew 4.1.6 Stryker 4.2 Market Forecast 4.3 Competitive Analysis Exhibit 4-1: 2010, Selected Insufflation Systems Exhibit 4-2: Aesculap's CO2 Insufflator Flow 40 System Exhibit 4-3: LEXION Medical's Insuflow Insufflation System Exhibit 4-4: Olympus America's UHI-3 High Flow Insufflator Exhibit 4-5: Olympus America's UCR Intraluminal Insufflation System Exhibit 4-6: Smith & Nephew's 400 Insufflator Exhibit 4-7: Stryker's PneumoSure 45L Insufflator Exhibit 4-8: Insufflation Products, Market Forecast, 2008-2013 Exhibit 4-9: 2009, Insufflation Products Market, Share by Supplier 5. ENDOSCOPES MARKET 5.1 Endoscopic Technology 5.2 Flexible Endoscopes 5.3 Rigid Endoscopes 5.4 Endoscopic Video Products 5.5 Types of Endoscopes 5.5.1 Choledochoscopes 5.5.2 Cystoscopes 5.5.3 Duodenoscopes 5.5.4 Falloposcopes 5.5.5 Hysteroscopes 5.5.6 Laparoscopes 5.5.7 Nephroscopes 5.5.8 Resectoscopes 5.5.9 Ureteroscopes 5.5.10 Urethroscopes 5.6 Products 5.6.1 ConMed Linvatec/ConMed 5.6.2 Envisionier Medical Technologies 5.6.3 Fujinon Endoscopy/Fujifilm Holdings 5.6.4 PENTAX/HOYA 5.6.5 Olympus America/Olympus 5.6.6 Smith & Nephew Endoscopy/Smith & Nephew 5.6.7 Karl Storz Endoscopy-America/Karl Storz 5.6.8 Stryker 5.6.9 Richard Wolf Medical Instruments/Richard Wolf 5.7 Market Forecast 5.8 Competitive Analysis Exhibit 5-1: 2010, Selected Endoscopes and Endoscopy Systems Exhibit 5-2: Envisionier Medical Technologies' endogo HD Portable Endoscopic Video Camera Exhibit 5-3: Fujinon Endoscopy's Double Balloon Endoscopy System Exhibit 5-4: Fujinon Endoscopy's Colonoscope, Duodenoscope, and Gastroscope Exhibit 5-5: PENTAX's EC-3890Li Video Colonoscope and EG-1580K Color Video Gastroscope Exhibit 5-6: PENTAX's EPK-i HD Digital Video and Image Processor Exhibit 5-7: Olympus America's Single Balloon Enteroscopy System Exhibit 5-8: Olympus America's Endo Capsule System Exhibit 5-9: Olympus America's Deflectable-Tip EndoEYE Laparoscope Exhibit 5-10: Olympus America's EndoEYE and HD EndoEYE Video Laparoscopes Exhibit 5-11: Olympus America's LTF-VH and LTF-VP Deflectable Tip Laparoscopes Exhibit 5-12: Olympus America's EVIS EXERA II Endoscopic Video Imaging Platform Exhibit 5-13: Representative Images of Olympus America's Rigid Laparoscopes and Flexible Hysteroscopes Exhibit 5-14: Olympus America's Flexible CYF-5/5A Fiber and CYF-V2/VA2 Video Cystoscopes Exhibit 5-15: Smith & Nephew Endoscopy's 560 Series High Definition Camera System Exhibit 5-16: Stryker's IDEAL EYES Laparoscopes Exhibit 5-17: Stryker's IDEAL EYES HD Articulating Laparoscope Exhibit 5-18: Richard Wolf's eyeMax CCD Cystoscope Exhibit 5-19: Endoscopes, Market Forecast, 2008-2013 Exhibit 5-20: 2009, Endoscopes Market, Share by Supplier 6. ENDOSCOPIC HAND INSTRUMENTS MARKET 6.1 Types of Endoscopic Hand Instruments 6.2 Products 6.2.1 Aesculap/B. Braun Melsungen 6.2.2 ConMed EndoSurgery/ConMed 6.2.3 Autosuture/Covidien 6.2.4 Ethicon Endo-Surgery/Johnson & Johnson 6.2.5 Olympus America/Olympus 6.2.6 Smith & Nephew 6.2.7 Karl Storz 6.2.8 Stryker 6.2.9 Others 22.214.171.124 Applied Medical Resources 126.96.36.199 Cambridge Endo/Cambridge Endoscopic Devices 188.8.131.52 Encision 184.108.40.206 Novare Surgical Systems 6.3 Market Forecast 6.4 Competitive Analysis Exhibit 6-1: 2010, Selected Endoscopic Hand Instruments Exhibit 6-2: Aesculap's AdTec Bipolar Laparoscopic Hand Instruments Exhibit 6-3: Aesculap's AdTec Needlescopic Mini Modular System Exhibit 6-4: Aesculap's AdTec Needle Holder Exhibit 6-5: ConMed EndoSurgery's Universal Plus Multifunction System Exhibit 6-6: Autosuture's MiniSite MiniShears and MiniPort Introducer System Exhibit 6-7: Autosuture's ENDO GIA Roticular and MULTIFIRE ENDO GIA 30 Stapler Exhibit 6-8: Covidien's Duet TRS Reload System Exhibit 6-9: Ethicon Endo-Surgery's Harmonic ACE Curved Shears Exhibit 6-10: Ethicon Endo-Surgery's Harmonic ACE Scissor Grip Exhibit 6-11: Ethicon Endo-Surgery's Dextrus Laparoscopic System Exhibit 6-12: Smith & Nephew's Dissecting and Grasping Instruments Exhibit 6-13: Smith & Nephew's Interceptre Laparoscopic Instruments Exhibit 6-14: Stryker's MiniLap Instrument Exhibit 6-15: Stryker's Laparoscopic Instruments Exhibit 6-16: Applied Medical Resources' Direct Drive Laparoscopic Instruments Exhibit 6-17: Cambridge Endo's Autonomy Laparo-Angle Articulating Instruments Exhibit 6-18: Encision's Active Electrode Monitoring Laparoscopic Instruments Exhibit 6-19: Novare Surgical Systems' RealHand High Dexterity Instruments Exhibit 6-20: Single-Port Laparoscopic Procedures that Utilize RealHand High Dexterity Instruments Exhibit 6-21: Endoscopic Hand Instruments, Market Forecast, 2008-2013 Exhibit 6-22: 2009, Endoscopic Hand Instruments Market, Share by Supplier 7. ENDOSCOPIC ACCESS SITE CLOSURE PRODUCTS MARKET 7.1 Products 7.1.1 Autosuture/Covidien 7.1.2 CooperSurgical 7.1.3 Ethicon/Johnson & Johnson 7.1.4 Paré Surgical 7.1.5 Orthovita 7.1.6 Richard Wolf Medical Instruments/Richard Wolf 7.2 Market Forecast 7.3 Competitive Analysis Exhibit 7-1: 2010, Selected Endoscopic Access Site Closure Products Exhibit 7-2: Autosuture's Endo Close Trocar Site Closure Device Exhibit 7-3: Autosuture's Endo Stitch Suturing Device Exhibit 7-4: CooperSurgical's CT CloseSure System Exhibit 7-5: Paré Surgical's gi-STITCH Flexible Endoscopic Suturing System Exhibit 7-6: Paré Surgical's Quik-Stitch Endoscopic Suturing System Exhibit 7-7: Orthovita's Vitagel Surgical Hemostat Exhibit 7-8: Richard Wolf Medical Instruments' Fascial Closure Kit Exhibit 7-9: Endoscopic Access Site Closure Products, Market Forecast, 2008-2013 Exhibit 7-10: 2009, Endoscopic Access Site Closure Products Market, Share by Supplier 8. ROBOTIC ASSISTED MINIMALLY INVASIVE SURGERY MARKET AND SURGICAL NAVIGATION SYSTEMS 8.1.1 Robotic-Assisted Surgical Systems 220.127.116.11 Curexo Technology 18.104.22.168 Intuitive Surgical 8.1.2 Surgical Navigation Systems 22.214.171.124 BrainLAB 126.96.36.199 GE Healthcare/General Electric 188.8.131.52 MediGuide/St. Jude Medical 184.108.40.206 Medtronic 220.127.116.11 Olympus America/Olympus 18.104.22.168 Stryker 22.214.171.124 Visionsense 8.1.3 Market Forecast-Robotic-Assisted Surgery 126.96.36.199 Emerging Technology Exhibit 8-1: 2010, Selected Robotic-Assisted Surgical Systems and Surgical Navigation Systems Exhibit 8-2: Selected Procedures Facilitated by the da Vinci Surgical System Exhibit 8-3: Intuitive Surgical's da Vinci S HD Surgical System Exhibit 8-4: Intuitive Surgical's da Vinci Si HD Surgical System Exhibit 8-5: Intuitive Surgical's EndoWrist Instrument Exhibit 8-6: Selected Screenshot of the BrainLAB Knee Essential Software Exhibit 8-7: GE Healthcare's InstaTrak 3500 Plus Surgical Navigation System Exhibit 8-8: Medtronic's FUSION Electromagnetic ENT Navigation System Exhibit 8-9: Olympus America's ScopeGuide Mobile Imaging System Exhibit 8-10: Stryker's iNtellect ENT Navigation Software and InfraVision Imaging System Exhibit 8-11: Visionsense's VSII Stereoscopic Vision System Exhibit 8-12: 2009, Intuitive Surgical's Financial and Procedural Growth Exhibit 8-13: Procedures that Employ Intuitive Surgical's da Vinci Surgical System Exhibit 8-14: Targeted Procedures for which the da Vinci Surgical System May Be Employed Exhibit 8-15: Robotic-Assisted Minimally Invasive Surgical Systems, Market Forecast, 2008-2013 9. COMPANY PROFILES 9.1 Advanced Surgical Concepts 9.2 Applied Medical Resources Corporation 9.3 ConMed EndoSurgery/ConMed Corporation 9.4 Covidien PLC 9.5 Fujinon Endoscopy/Fujifilm Holdings Corporation 9.6 Intuitive Surgical, Inc. 9.7 Johnson & Johnson 9.8 Olympus America, Inc./Olympus Corporation 9.9 Smith & Nephew PLC 9.10 Karl Storz GmbH & Co. KG 9.11 Stryker Endoscopy/Stryker Corporation 9.12 SurgiQuest, Inc. 9.13 TransEnterix, Inc. 9.14 USGI Medical, Inc. 9.15 Richard Wolf GmbH APPENDIX: COMPANY LISTING