350 Pages | 121 Exhibits | 2010 Analysis | Forecasts Through 2013 Product Family: Market Reports

Endoscopic surgery is a minimally invasive, closed procedure (as opposed to invasive open surgery where the surgeon cuts open the body to reach diseased tissue or organs). In endoscopic and laparoscopic procedures the targeted surgical site is accessed via natural orifices of the body or through access ports created by the surgeon at selected positions. The surgeon must abandon a direct, open view of the surgical site for images acquired by an endoscope that combines lighting and optics. However, due to several advantages-including reduced trauma, reduced scarring, and shorter patient recovery and cost-the types of procedures performed endoscopically continue to rapidly expand, driving market growth. Today, endoscopic surgery includes a growing number of specialty procedures in fields such as gastroenterology; obstetrics and gynecology; orthopedics; otolaryngology; thoracic surgery; and urological surgery. General and pelvic endoscopic/laparoscopic surgeries such as gastric bypass, endometrial ablation, laparoscopically assisted vaginal hysterectomy (LAVH), appendectomy, and prostatectomy totaled more than 2.8 million in 2008.

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.


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


1.1 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 Access Needles 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 Clamps and Needle Holders Clip Appliers Forceps Graspers and Retractors Pencils and Dissectors Scissors Staplers
	1.4.7 Insufflation Devices Traditional Insufflation Gasless Insufflation
	1.4.8 Suction/Irrigation and Fluid Management Systems
	1.4.9 Ancillary Devices Used in Endoscopic Surgical Procedures Mechanical Assist Devices Specimen Retrieval Bags 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


2.1 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 Vertical Banded Gastroplasty Roux-en-Y Gastric Bypass 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 Cryoablation 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


3.1 Single-Incision Laparoscopy
	3.1.1 Natural Orifice Translumenal Endoscopic Surgery
	3.1.2 Market Analysis Covidien Ethicon Endo-Surgery/Johnson & Johnson Olympus America/Olympus Patient Outcomes Economics Consumer Demand
3.2 Types of Access Devices
	3.2.1 Access Needles ConMed EndoSurgery/ConMed Autosuture/Covidien Ethicon Endo-Surgery/Johnson & Johnson Medovations Richard Wolf Medical Instruments/Richard Wolf Market Forecast Competitive Analysis
	3.2.2 Trocars and Single-Port Access/Incisionless Access Systems Advanced Surgical Concepts/Olympus America/Olympus Applied Medical Resources Aesculap/B. Braun Melsungen Cardinal Health ConMed EndoSurgery/ConMed Autosuture/Covidien Ethicon Endo-Surgery/Johnson & Johnson Olympus America/Olympus Karl Storz Endoscopy-America/Karl Storz SurgiQuest TransEnterix USGI Medical Richard Wolf Medical Instruments/Richard Wolf Market Forecast-Trocars Competitive Analysis
	3.3.3 Hand-Assisted Laparoscopic Surgery Devices Applied Medical Resources Ethicon Endo-Surgery/Johnson & Johnson Market Forecast 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


4.1 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


5.1 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
	5.6.5 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


6.1 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 Applied Medical Resources Cambridge Endo/Cambridge Endoscopic Devices Encision 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


7.1 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


	8.1.1 Robotic-Assisted Surgical Systems Curexo Technology Intuitive Surgical
	8.1.2 Surgical Navigation Systems BrainLAB GE Healthcare/General Electric MediGuide/St. Jude Medical Medtronic Olympus America/Olympus Stryker Visionsense
	8.1.3 Market Forecast-Robotic-Assisted Surgery 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


9.1 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



  1. Advanced Surgical Concepts
  2. Applied Medical Resources Corporation
  3. ConMed EndoSurgery/ConMed Corporation
  4. Covidien PLC
  5. Fujinon Endoscopy/Fujifilm Holdings Corporation
  6. Intuitive Surgical, Inc.
  7. Johnson & Johnson
  8. Olympus America, Inc./Olympus Corporation
  9. Smith & Nephew PLC
  10. Karl Storz GmbH & Co. KG
  11. Stryker Endoscopy/Stryker Corporation
  12. SurgiQuest, Inc.
  13. TransEnterix, Inc.
  14. USGI Medical, Inc.
  15. Richard Wolf GmbH
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