The Market for Minimally Invasive Medical Devices

Publication Date	January 2009
Publisher	BCC Research
Product Type	Report
Pages	144
ISBN Number	not applicable
Product Code	BCC00281

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Summary

Minimally Invasive Surgery

Minimally invasive surgery is performed without making a major incision or opening, resulting in less trauma for the patient and yielding significant cost savings. These result from shorter hospitalization times and reduced therapy requirements. Other benefits of minimally invasive surgery are less pain, less need for postsurgical pain medication, less scarring, and less likelihood of complications related to the incision.

Thus, minimally invasive surgery is defined either as based on the operative procedure (e.g., small incisions) or the outcome (reduced surgical complications or costs). However, minimally invasive is not the same as minor surgery. Some "minimally invasive" procedures, (e.g., coronary artery bypass surgery), still are major operations requiring a hospital stay.

in minimally invasive surgery, a miniature camera is introduced into the body through a small incision. IT transmits images to a video monitor, enabling the physician to diagnose and, if necessary, treat a variety of conditions. to do this, the physician inserts surgical instruments and auxiliary devices, such as irrigation and drainage devices, through one or more small incisions.

Minimally invasive surgery shares some important characteristics, but should not be confused with either ambulatory ("walk-in") or noninvasive surgery.

Minimally Invasive vs. Ambulatory Surgery

Some types of minimally invasive surgery can be performed in an ambulatory (nonhospital) setting, but minimally invasive surgery is not necessarily identical with ambulatory surgery. Attempts to delineate minimally invasive from ambulatory surgery on the basis of incision size or use of an endoscope or other device to look inside the patient's body run into too many exceptions to be very useful.

Perhaps the best way to distinguish minimally invasive surgery from other types of ambulatory surgery is to define it as surgery that, if performed using conventional open-incision techniques, requires hospital admission. This definition excludes such minor surgical procedures as vasectomies. These almost never are performed separately in a hospital setting.

Minimally Invasive vs. Noninvasive Surgery

in a sense, the ultimate in minimally invasive surgery does not require any incision or physical entry into the patient's body. Examples include the use of ultrasound to break up gallstones and radiation to shrink or kill tumors. for purposes of this report, only those surgical procedures that involve physical access to the body through an incision or a natural orifice are considered minimally invasive surgery.

Study Background

A growing number of surgical procedures are carried out using minimally invasive techniques. This has created a multibillion-dollar market for the specialized devices and instruments used for these procedures. They include monitors and imaging equipment, electrosurgical devices, handheld instruments, auxiliary devices and accessories.

Because the use of these products is increasing so rapidly, there is a pressing need to develop an up-to-date base of market information to better understand the dynamics of the market for minimally invasive surgical devices and instruments. Nearly 3 years have passed since BCC Research published the previous edition of this study, Trends in the Noninvasive and Minimally Invasive Medical Device Market (HLC051D). IT analyzed key growth areas, and developed quantitative market projections.

since then, the market has continued to evolve. The population of the established markets is aging, bringing new surgical needs, while new markets are opening up. Technological advances have expanded the range of surgical procedures that can be performed using minimally invasive techniques, while giving physicians new tools for the diagnosis and treatment of injuries and pathologies.

Meanwhile, the structure of the health care industry is changing, as traditional hospitals consolidate and other health care options become available to consumers. This study attempts to give management readers the information and analysis they need to deal with these challenges.

Study Goals and Objectives

This study meets these needs by analyzing global markets for minimally invasive surgical devices and instruments (see Scope and Format for a definition of these devices) in light of the most recent available information. in addition to looking at current and future markets, the study will analyze technological, demographic, and economic developments that may have a long-term impact on the size and structure of the market for minimally invasive devices and instruments.

This report also provides an analysis of the market for minimally invasive devices and instruments by type of surgical procedure, device, end user, and region. The future of minimally invasive surgical equipment also will be discussed, with forecasts for consumption of specific products.

More Specific Objectives Are to:

Identify and segment the main types of minimally invasive devices and instruments that have been commercialized to date
Analyze the historical and current volume and value of shipments of each of these product segments in specified end user and geographic markets
Identify and evaluate the impact of demographic, economic, and other factors that will drive future demand for minimally invasive devices
Forecast the volume and value of shipments of the product segments by the probabilities that future demand will be higher or lower than the baseline forecast
Identify promising new surgical procedures and products still in the development and testing stage, and assess the probability they will be commercialized successfully in the next 5 years
Forecast the potential market for these developmental procedures and products, taking into account the estimated probability they will be commercialized
Identify leading device manufacturers and analyze the structure of the minimally invasive surgical devices industry (e.g., market shares, concentration, and recent m&a activity)
Assess the long-term outlook for minimally invasive surgical devices, taking into account market opportunities, as well as technological, financial and economic factors.

Intended Audience

The report has been written for the minimally invasive surgical interest community, but is especially tailored for readers with an interest in the marketing and management dimensions of minimally invasive surgical devices and instruments. This especially includes readers in:

The medical and surgical devices industry
Medical research institutions
The investment community
The financial and analyst community

Scope of Report

This report is an analytical business tool whose primary purpose is to describe the minimally invasive surgical devices industry and the U.S. market for these devices. The scope of the study does not include:

Devices and instruments used exclusively for traditional open surgical procedures (e.g., heart-lung machines)
Devices and equipment used exclusively in an ambulatory surgery setting
Equipment for nonsurgical types of therapy such as radiation therapy.

The format of the study is organized around the following topics:

Major types and applications of minimally invasive surgical devices and instruments.
Industry structure.
Market size and segmentation, including historical data on sales by application, product type, end-user group and geographical market.
Market drivers.
Detailed market projections through 2014.
Competition and market shares.
Observations and conclusions regarding the future of minimally invasive surgical devices and instruments.

Content

Chapter One: Introduction
- Minimally Invasive Surgery
  - Minimally Invasive vs. Ambulatory Surgery
  - Minimally Invasive vs. Noninvasive Surgery
- Study Background
- Study Goals and Objectives
- Intended Audience
- Scope of Report
- Methodology and Information Sources
- Analyst Credentials
- Related BCC Research Studies
- BCC Online Services
- Disclaimer
Chapter Two: Executive Summary
- Executive Summary
Chapter Three: Overview of Minimally Invasive Surgical Devices and Instruments
- General Description
- History of Minimally Invasive Surgery
  - Endoscopy
  - Insufflation
  - Specialized Surgical Instruments
  - Minimally Invasive Surgical Procedures
  - Surgical Robotics
- Surgical Trends and The Growing Importance of Minimally Invasive Surgery
- Principal Applications of Minimally Invasive Surgery
  - Gastrointestinal Surgery
    - Gallbladder Removal (Cholecystectomy)
    - Nissen Fundoplication (Antireflux Operation)
    - Adhesiolysis (Removal of Abdominal Scar Tissue)
    - Appendectomy
    - Gastric Bypass
    - Colon Resection
    - Hernia Repair
  - Gynecology
    - Hysterectomies
    - Myomectomy
    - Endometrial Ablation
    - Pelvic Floor Reconstruction
    - Adnexectomy (Removal of Adnexal Structures)
  - Urology
    - Nephrectomy
    - Cystocele/Rectocele Repair
    - Pediatric Urology
    - Adrenalectomy
    - Radical Prostatectomy
  - Cosmetic Surgery
    - Breast Augmentation
    - Face and Forehead Lifts
  - Thoracic Surgery
    - Lung Biopsies
    - Lung Resection
    - Endoscopic Thoracic Sympathectomy
  - Cardiothoracic Surgery
    - Angioplasty and Other Catheterization Types
    - Coronary Artery Bypass
    - Heart Valve Repair and Replacement
    - Congenital Heart Defect Surgery
  - Noncardiac Vascular Surgery
    - Saphenous Vein Harvest
    - Peripheral Vascular Bypass
    - Aortoiliofemoral Bypass
    - Abdominal Aortic Aneurism Repair
    - Lower Extremity Angioplasty
  - Orthopedic Surgery
    - Joint Surgery
    - Arthroscopic Surgery
    - Arthroplasty
    - Damaged or Diseased Spinal Disk Surgery
    - Microendoscopic Diskectomy
    - Intradiscal Electrothermal Annuloplasty
    - Vertebroplasty and Kyphoplasty
- Product Types
  - Monitoring/Visualization Equipment
  - Robotically Assisted Surgical Systems
  - Electrosurgical Equipment
  - Mechanical Instruments
  - Auxiliary Equipment
  - Surgical Devices
- Regulatory Status of Mis Equipment
  - United States
  - European Union (Eu)
  - Japan
- End-User Segments
  - Hospital Surgical Departments
  - Outpatient Surgery Centers
  - Group Practices
  - Individual Surgeons
  - Medical Schools
Chapter Four: Market for Mis Devices and Equipment by Type, Application Segments and User Segments
- Overall Market Size and Segmentation
  - Geographic Segments
  - Application Segments
  - Device and Equipment Segments
  - End-User Segments
- Detailed Market Analysis
  - Minimally Invasive Gastrointestinal Surgery
    - Current Status
    - Market Drivers
    - Demographic Trends
    - Trends in Obesity Surgery
    - Projected Market Trends
  - Minimally Invasive Gynecological Surgery
    - Current Status
    - Market Drivers
    - Demographic Trends
    - Introduction of Robotic Gynecological Surgery
    - Projected Market Trends
  - Minimally Invasive Urological Surgery
    - Current Status
    - Market Drivers
    - Trends in The Incidence of Certain Cancers
    - Demographic Trends
    - Technological Trends
    - Projected Market Trends
  - Minimally Invasive Cosmetic Surgery
    - Current Status
    - Market Drivers
    - Projected Market Trends
  - Minimally Invasive Thoracic Surgical Procedures
    - Current Status
    - Market Drivers
    - Incidence of Lung Cancer
    - Sympathectomy Trends
    - Projected Market Trends
  - Minimally Invasive Cardiac Surgery
    - Current Status
    - Market Drivers
    - Demographic Trends
    - Trends in The Occurrence of Cardiovascular Disease
    - Trends in Numbers of Cardiovascular Surgeons
    - Development of New Mis Techniques
      - Transcatheter Cardiac Surgery
      - Transcatheter Dmr
      - Transcatheter Hole Closure
      - Other Transcatheter Procedures
      - Robot-Assisted Cardiac Surgery
    - Projected Market Trends
  - Minimally Invasive Noncardiac Vascular Surgery
    - Current Status
    - Market Drivers
    - Projected Market Trends
  - Minimally Invasive Orthopedic Surgery
    - Current Status
    - Market Drivers
    - Arthroscopy Procedures
    - Joint Replacements
    - Spinal Disc Surgery
    - Vertebroplasty/Kyphoplasty
    - Projected Market Trends
- Market by Type of Device and Equipment
Chapter Five: Industry Structure, Competition and Market Shares
- Industry Structure
- Competition and Market Shares
  - Monitoring/Visualization Equipment
- Robotics/Computer-Assisted Surgery
- Electrosurgical Equipment
- Surgical Instruments
- Surgical Devices
Chapter Six: Conclusions: The Outlook for Minimally Invasive Surgical Devices and Instruments
- Major Developments That Will Influence The Minimally Invasive Surgical Devices and Instruments Industry
  - Technological Developments
    - Adaptation of Minimally Invasive Techniques to New Types of Surgical Procedures
    - Natural Orifice Transluminal Endoscopic Surgery
    - New Technologies
    - Nonvisual Imaging Techniques
      - Optical Imaging Technologies
      - Nonoptical Imaging Technologies
      - "hybrid" Optical/Nonoptical Systems
    - Robotics
    - Computer-Assisted Surgery
    - Transcatheter Surgery
    - Percutaneous Ablation
    - Transcatheter Methods
    - Radio Frequency Ablation
    - Microwave Ablation
  - Demographic and Economic Trends
    - Aging Populations Worldwide
    - Income Growth in Emerging Markets
  - Changing Structure of The Health Care Industry
    - Hospital Consolidation
    - Health Insurance Developments
- Long-Term Outlook for Minimally Invasive Surgical Devices and Instruments
- Appendix A: Minimally Invasive Surgical Procedures
- Abdominal Surgery
- Cardiac Surgery
- Endocrine Surgery
- Gynecology
- Neurosurgery
- Orthopaedic Surgery
- Pediatrics
- Plastic Surgery
- Thoracic
- Urology
- Vascular
Appendix B: Vendor Profiles
- Acueity, Inc
- Arthrocare Corp
- Biosearch Medical Products, Inc
- Boston Scientific
- B. Braun Aesculap
- Clarus Medical Llc
- Conmed Corp
- Cooper Surgical, Inc
- C R. Bard, Inc
- Encision, Inc
- Ethicon Endo-Surgery, Inc
- Fujinon Photo Optical Co , Ltd
- Gyrus Acmi Corp
- Integra Life Sciences Holdings
- Integrated Endoscopy
- Intuitive Surgical, Inc
- Jarit Surgical Instruments
- Karl Storz Endoskope Berlin Gmbh & Co
- Medtronic, Inc
- Medtronic Ent, Inc
- Mentice Medical Simulation Ab
- Mgb Endoscopy, Ltd
- Microdexterity Systems, Inc
- Olympus Optical Co , Ltd
- Pentax Corp
- Pilling Surgical
- Rema Medizintechnik Gmbh
- Richard Wolf Gmbh
- Smith & Nephew Plc
- Stryker Corp
- Surgical Innovations Group Plc
- United States Surgical Corp
- Urs Universal Robot Systems
- Valleylab
- Vision Sciences, Inc
Appendix C: Industry and Professional Organizations
- American Association of Gynecological Laparoscopists
- American College of Surgeons
- American Medical Association
- American Society for Gastrointestinal Endoscopy
- Association for The Advancement of Medical Instrumentation
- European Association for Endoscopic Surgery
- The International Society for Minimally Invasive Cardiac Surgery
- Society of American Gastrointestinal Endoscopic Surgeons
- Society of Laparoendoscopic Surgeons
List of Summaries
- Summary Table Global Market for Mis Devices and Equipment, through 2014 ($ Billions)
- Summary Figure Global Market for Mis Devices and Equipment, 2007-2014 ($ Billions)
List of Tables
- Table 1 Surgical Procedures Commonly Performed in The U S. Using A Minimally Invasive Approach, 2007
- Table 2 Principal Types of Monitoring/Visualization Equipment
- Table 3 Principal Types of Surgical Robotic Systems
- Table 4 Electrosurgical Equipment
- Table 5 Principal Types of Mechanical Instruments
- Table 6 Principal Types of Auxiliary Equipment Used for Minimally Invasive Surgery
- Table 7 Minimally Invasive Surgical Devices
- Table 8 U S. Surgical Specialties, 2007 (Number and % of All U S. Surgeons)
- Table 9 Global Sales of Mis Devices and Equipment, through 2014 ($ Billions)
- Table 10 Market for Mis Devices and Equipment Sales by Region, through 2014 ($ Millions)
- Table 11 U S. Markets for Mis Devices and Equipment Sales by Application, through 2014 ($ Millions)
- Table 12 U S. Markets for Mis Sales by Equipment Type, through 2014 ($ Millions)
- Table 13 U S. Markets for Mis Devices and Equipment Sales by End-User Type, through 2014 ($ Millions)
- Table 14 Projected Number of Persons 18 Years and Older in The U S , through 2014 (Millions of Persons)
- Table 15 Projected Trends in Minimally Invasive Gastrointestinal Procedures, through 2014 (Number of Procedures)
- Table 16 Projected U S. Demand for Mis Devices and Equipment Used for Gastrointestinal Surgery, through 2014 ($ Millions)
- Table 17 Projected Number of U S. Women Ages 40 to 54, through 2014 (Millions of Women)
- Table 18 Projected Trends in Minimally Invasive Gynecological Procedures, through 2014 (Number of Procedures)
- Table 19 Projected U S. Demand for Mis Devices and Equipment Used for Gynecological Surgery, through 2014 ($ Millions)
- Table 20 Number of New Cases of Selected Cancers, 1998-2007 (Thousands)
- Table 21 Trend in Number of U S. Women over 45, through 2014 (Millions)
- Table 22 Trend in Number of U S. Boys under Five, through 2014 (Millions)
- Table 23 Projected Trends in Minimally Invasive Urological Procedures, through 2007 (Number of Procedures)
- Table 24 Projected U S. Demand for Mis Devices and Equipment Used for Urological Surgery, through 2014 ($ Millions)
- Table 25 Number of U S. Cosmetic Surgery Procedures, 2000-2007 (Thousand Procedures)
- Table 26 Projected Trends in Minimally Invasive Cosmetic Surgical Procedures, through 2014 (Number of Procedures)
- Table 27 Projected U S. Demand for Mis Devices and Equipment Used for Cosmetic Surgery, through 2007 ($ Millions)
- Table 28 U S. Lung Cancer Trends, through 2007 (Thousand New Cases)
- Table 29 Projected Trends in Minimally Invasive Thoracic Procedures, through 2014 (Number of Procedures)
- Table 30 Projected U S. Demand for Mis Devices and Equipment Used for Thoracic Surgery, through 2014 ($ Millions)
- Table 31 Projected U S. Demand for Mis Devices and Equipment Used in Cardiac Surgery, through 2014 ($ Millions)
- Table 32 Projected U S. Demand for Mis Devices and Equipment Used in Vascular Surgery, through 2014 ($ Millions)
- Table 33 Projected Trends in Minimally Invasive Orthopedic Procedures, through 2014 (Number of Procedures)
- Table 34 Projected U S. Demand for Mis Devices and Equipment Used in Orthopedic Surgery, through 2014 ($ Millions)
- Table 35 Projected Mis Market Device/Equipment Segments by Application, through 2014 ($ Millions)
- Table 36 U S. Medical and Surgical Equipment Manufacturers by Employment Size and Sales Category
- Table 37 Global Monitoring/Visualization Market Shares, 2007
- Table 38 Global Robotics/Computer-Assisted Surgery Market Shares, 2007
- Table 39 Electrosurgical and Auxiliary Equipment Market Shares, 2007
- Table 40 Global Endosurgical Instrument Market Shares, 2007
- Table 41 Global Coronary Stent Market Shares, 2007
- Table 42 Trends in Age Composition of The World's Population, through 2015 (Millions)
- Table 43 Projected Trends in per Capita Real Gdp Growth, by Region, 2006-2010 (Annual Average Percentage Change)
List of Figures
- Figure 1 Mis Procedures as A Percent of All Surgical Procedures Performed in The U S , 2007 (%)
- Figure 2 Mis Procedures as A Percentage of Selected Types of Surgical Measures in The U S , 2007 (%)
- Figure 3 Surgical Procedures Performed in The U S Using All Mis Approaches, 2007 (% of All Mis Procedures)
- Figure 4 U S. Hospitals with Surgery Departments, 2008 (Number of Hospitals)
- Figure 5 U S. Surgical Specialties, 2007 (% of All U S Surgeons)
- Figure 6 Trends in Global Sales of Mis Devices and Equipment, 2007-2014 ($ Billions)
- Figure 7 Major Mis Geographic Segments, 2007 vs. 2014 (% of Total Sales)
- Figure 8 Major U S. Mis Application Segments, 2007 vs 2014 (% of Total Sales)
- Figure 9 Major U S. Mis Equipment Segments, 2007 vs. 2014 (% of Total Sales)
- Figure 10 Major U S. Mis End-User Segments, 2007 vs 2014 (% of Total Sales)
- Figure 11 U S. Market for Mis Devices and Equipment Used in Gastrointestinal Surgery, 2007 (% of Total Sales)
- Figure 12 U S. Market for Mis Devices and Equipment Used for Gynecological Surgery, 2007 (% of Total Sales)
- Figure 13 U S. Market for Mis Devices and Equipment Used for Urological Surgery, 2007 (% of Total Sales)
- Figure 14 U S. Market for Mis Devices and Equipment Used in Cosmetic Surgery, 2007 (% of Total Sales)
- Figure 15 Trends in Selected U S. Cosmetic Surgery Procedures, 2000-2007 (Thousand Procedures)
- Figure 16 U S. Market for Mis Devices and Equipment Used in Thoracic Surgery, 2007 (% of Total Sales)
- Figure 17 U S. Market for Mis Devices and Equipment Used for Cardiac Surgery, 2007 (% of Total Sales)
- Figure 18 U S. Market for Mis Devices and Equipment Used in Noncardiacvascular Surgery, 2007 (% of Total Sales)
- Figure 19 U S. Market for Mis Devices and Equipment Used in Orthopedic Surgery, 2007 (% of Total Sales)
- Figure 20 Employee Numbers and Sales Distribution of U S. Medical and Surgical Equipment Manufacturers (% of All Establishments)
- Figure 21 Monitoring/Visualization Equipment Market Leaders, 2007 (% of Total Segment Sales)
- Figure 22 Robotics/Computer-Assisted Surgery Market Leaders, 2007 (% of Total Sales)
- Figure 23 Global Electrosurgical and Auxiliary Equipment Market Leaders, 2007 (% of Total Sales)
- Figure 24 Endosurgical Instrument Market Leaders, 2007 (% of Total Sales)
- Figure 25 Cornonary Stent Market Leaders, 2007 (% of Total Sales)