U.S. MARKET FOR LAPAROSCOPIC DEVICES · U.S. MARKET FOR LAPAROSCOPIC DEVICES iDATA_USLAP15_RPT Published in January 2015 By iData Research Inc., 2015 iData Research Inc. Suite 308

U.S. MARKET FOR LAPAROSCOPIC DEVICES

iDATA_USLAP15_RPT

Published in January 2015

By

iData Research Inc., 2015

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TABLE OF CONTENTS

© iData Research Inc., 2015 i

T A B L E O F C O N T E N T S

TABLE OF CONTENTS ............................................................................................................... I

LIST OF FIGURES .................................................................................................................... XI

LIST OF CHARTS.................................................................................................................. XVII

EXECUTIVE SUMMARY ............................................................................................................ 1

1.1 U.S. LAPAROSCOPIC DEVICE MARKET ........................................................................................ 1

1.2 TREND ANALYSIS BY SEGMENT ................................................................................................... 2

1.3 LAPAROSCOPIC PROCEDURES ...................................................................................................... 3

1.4 LAPAROSCOPE MARKET .............................................................................................................. 4

1.5 ACCESS DEVICE MARKET ............................................................................................................ 5

1.6 DIRECT ENERGY DEVICE MARKET .............................................................................................. 6

1.7 ULTRASONIC DEVICE MARKET.................................................................................................... 7

1.8 CLOSURE DEVICE MARKET ......................................................................................................... 8

1.9 POWERED MORCELLATOR MARKET ............................................................................................ 9

1.10 LEADING COMPETITORS .......................................................................................................... 10

RESEARCH METHODOLOGY................................................................................................ 11

2.1 RESEARCH SCOPE ...................................................................................................................... 11

2.2 IDATA’S 9-STEP METHODOLOGY .............................................................................................. 11

Step 1: Project Initiation & Team Selection ................................................................................... 11

Step 2: Prepare Data Systems and Perform Secondary Research .................................................. 13

Step 3: Preparation for Interviews & Questionnaire Design .......................................................... 14

Step 4: Performing Primary Research ............................................................................................ 15

Step 5: Research Analysis: Establishing Baseline Estimates ......................................................... 17

Step 6: Market Forecast and Analysis ............................................................................................ 18

Step 7: Identify Strategic Opportunities ......................................................................................... 20

Step 8: Final Review and Market Release ..................................................................................... 21

Step 9: Customer Feedback and Market Monitoring ..................................................................... 22

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U.S. LAPAROSCOPIC DEVICE MARKET OVERVIEW..................................................... 23

3.1 INTRODUCTION .......................................................................................................................... 23

3.2 MARKET OVERVIEW .................................................................................................................. 24

3.3 TREND ANALYSIS BY SEGMENT ................................................................................................. 28

3.4 DRIVERS AND LIMITERS ............................................................................................................ 31

3.4.1 Market Drivers ...................................................................................................................... 31

3.4.2 Market Limiters ..................................................................................................................... 31

3.5 COMPETITIVE ANALYSIS ........................................................................................................... 34

3.6 HERFINDAHL INDEX .................................................................................................................. 40

3.7 MERGERS AND ACQUISITIONS ................................................................................................... 42

3.8 MARKET TRENDS ...................................................................................................................... 44

3.8.1 Full Product Lines Through a Single Vendor ....................................................................... 44

3.8.2 Preference With Surgical Subspecialty ................................................................................. 44

3.8.3 Supplier Procedure Promotion .............................................................................................. 44

3.8.4 Multifunctional Devices ........................................................................................................ 44

3.9 EMERGING TECHNOLOGIES ....................................................................................................... 45

3.9.1 Robotics in Laparoscopic Surgery ........................................................................................ 45

3.9.2 Surgical Smoke Evacuation Systems .................................................................................... 45

3.9.3 Minilap Instruments .............................................................................................................. 46

3.9.4 3D Laparoscopic Systems ..................................................................................................... 46

PROCEDURE NUMBERS.......................................................................................................... 49

4.1 INTRODUCTION .......................................................................................................................... 49

4.2 LAPAROSCOPIC PROCEDURE NUMBER OVERVIEW .................................................................... 50

4.2.1 Laparoscopic Procedure Numbers by Type .......................................................................... 50

4.2.2 Open Procedure Numbers by Type ....................................................................................... 54

4.2.3 Open and Laparoscopic Procedure Numbers by Type .......................................................... 57

4.3 LAPAROSCOPIC PROCEDURE NUMBERS BY STATE ..................................................................... 60

4.4 GASTRIC BAND PROCEDURE NUMBERS ..................................................................................... 63

4.4.1 By Placement/Removal ......................................................................................................... 64

4.4.2 Outpatient by Placement/Removal ........................................................................................ 65

4.4.3 Inpatient by Placement/Removal .......................................................................................... 66

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4.5 GASTRIC BYPASS PROCEDURE NUMBERS .................................................................................. 67

4.5.1 Total ...................................................................................................................................... 68

4.5.2 Outpatient .............................................................................................................................. 69

4.5.3 Inpatient ................................................................................................................................. 70

4.6 SLEEVE GASTRECTOMY PROCEDURE NUMBERS ........................................................................ 71

4.6.1 By Open/Laparoscopic .......................................................................................................... 72

4.6.2 Outpatient by Open/Laparoscopic ......................................................................................... 73

4.6.3 Inpatient by Open/Laparoscopic ........................................................................................... 74

4.7 ANTI-REFLUX PROCEDURE NUMBERS ....................................................................................... 75




4.8 COLECTOMY PROCEDURE NUMBERS ......................................................................................... 79




4.9 CHOLECYSTECTOMY PROCEDURE NUMBERS ............................................................................. 83




4.10 NEPHRECTOMY PROCEDURE NUMBERS ................................................................................... 87

4.10.1 By Open/Laparoscopic ........................................................................................................ 88

4.10.2 Outpatient by Open/Laparoscopic ....................................................................................... 89

4.10.3 Inpatient by Open/Laparoscopic ......................................................................................... 90

4.11 APPENDECTOMY PROCEDURE NUMBERS ................................................................................. 91




4.12 ADRENALECTOMY PROCEDURE NUMBERS .............................................................................. 95




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4.13 HERNIA REPAIR PROCEDURE NUMBERS .................................................................................. 99

4.13.1 By Open/Laparoscopic ...................................................................................................... 101

4.13.2 Outpatient by Open/Laparoscopic ..................................................................................... 102

4.13.3 Inpatient by Open/Laparoscopic ....................................................................................... 103

4.14 HYSTERECTOMY PROCEDURE NUMBERS ............................................................................... 104

4.14.1 By Open/Laparoscopic ...................................................................................................... 105

4.14.2 Outpatient by Open/Laparoscopic ..................................................................................... 106

4.14.3 Inpatient by Open/Laparoscopic ....................................................................................... 107

4.15 FEMALE STERILIZATION PROCEDURE NUMBERS BY OPEN/LAPAROSCOPIC ........................... 108

4.16 ANALYSIS FOR OTHER PROCEDURES ..................................................................................... 110

4.16.1 Pediatric Laparoscopy ....................................................................................................... 110

4.16.2 Laparoscopic Cardiomyotomy (Heller Myotomy) ............................................................ 110

4.16.3 Laparoscopic Placation of a Perforated Ulcer ................................................................... 110

4.16.4 Elective Diagnostic Laparoscopy and Cancer Staging ..................................................... 110

LAPAROSCOPE MARKET ..................................................................................................... 111

5.1 INTRODUCTION ........................................................................................................................ 111

5.2 MARKET OVERVIEW ................................................................................................................ 112

5.3 MARKET ANALYSIS AND FORECAST ........................................................................................ 116

5.3.1 Total Laparoscope Market .................................................................................................. 116

5.3.2 Rod Lens Laparoscope Market ........................................................................................... 118

5.3.3 Video Laparoscope Market ................................................................................................. 121

5.4 DRIVERS AND LIMITERS .......................................................................................................... 123

5.4.1 Market Drivers .................................................................................................................... 123

5.4.2 Market Limiters ................................................................................................................... 124

5.5 COMPETITIVE ANALYSIS ......................................................................................................... 125

ACCESS DEVICE MARKET ................................................................................................... 129

6.1 INTRODUCTION ........................................................................................................................ 129

6.2 MARKET OVERVIEW ................................................................................................................ 130


6.3.1 Total Access Device Market ............................................................................................... 133

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6.3.2 Total Trocar Market ............................................................................................................ 135

6.3.2.1 Reusable Trocar Market ........................................................................................................ 138

6.3.2.2 Disposable Trocar Market ..................................................................................................... 140

6.3.2.3 Reposable Trocar Market ...................................................................................................... 142

6.3.3 Single Port Access Device Market ...................................................................................... 144


6.4.1 Market Drivers .................................................................................................................... 146

6.4.2 Market Limiters ................................................................................................................... 146


HAND INSTRUMENT MARKET ........................................................................................... 151

7.1 INTRODUCTION ........................................................................................................................ 151

7.2 MARKET OVERVIEW ................................................................................................................ 153


7.3.1 Total Hand Instrument Market ............................................................................................ 157

7.3.2 Reusable Hand Instrument Market ...................................................................................... 159

7.3.3 Disposable Hand Instrument Market ................................................................................... 161

7.3.4 Reposable Hand Instrument Market .................................................................................... 163

7.3.5 Articulating Hand Instrument Market ................................................................................. 165


7.4.1 Market Drivers .................................................................................................................... 167

7.4.2 Market Limiters ................................................................................................................... 167


INSUFFLATION DEVICE MARKET .................................................................................... 175

8.1 INTRODUCTION ........................................................................................................................ 175

8.2 MARKET OVERVIEW ................................................................................................................ 176


8.3.1 Total Insufflation Device Market ........................................................................................ 179

8.3.2 Insufflator Market ............................................................................................................... 181

8.3.3 Veress Needle Market ......................................................................................................... 184

8.3.4 Total Insufflator Tubing Market ......................................................................................... 186

8.3.4.1 Standard Insufflator Tubing Market ....................................................................................... 188

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8.3.4.2 Heated Insufflator Tubing Market .......................................................................................... 190


8.4.1 Market Drivers .................................................................................................................... 192

8.4.2 Market Limiters ................................................................................................................... 193


SUCTION-IRRIGATION DEVICE MARKET ...................................................................... 199

9.1 INTRODUCTION ........................................................................................................................ 199

9.2 MARKET OVERVIEW ................................................................................................................ 200


9.3.1 Total Suction-Irrigation Device Market .............................................................................. 203

9.3.2 Total Disposable Kit Market ............................................................................................... 205

9.3.2.1 Battery-Powered Disposable Kit Market ................................................................................ 207

9.3.2.2 Hybrid Disposable Kit Market ............................................................................................... 209

9.3.2.3 Capital Equipment Disposable Kit Market ............................................................................. 211

9.3.3 Total Reusable Tip Market .................................................................................................. 213

9.3.3.1 Electrocautery Reusable Tip Market ...................................................................................... 215

9.3.3.2 Standard Reusable Tip Market ............................................................................................... 217

9.3.4 Suction-Irrigation Pump Market ......................................................................................... 219


9.4.1 Market Drivers .................................................................................................................... 221

9.4.2 Market Limiters ................................................................................................................... 221


DIRECT ENERGY DEVICE MARKET ................................................................................. 225

10.1 INTRODUCTION ...................................................................................................................... 225

10.2 MARKET OVERVIEW .............................................................................................................. 226

10.3 MARKET ANALYSIS AND FORECAST ...................................................................................... 229

10.3.1 Total Direct Energy Device Market .................................................................................. 229

10.3.2 Reusable Standard Bipolar Device Market ....................................................................... 231

10.3.3 Disposable Advanced Bipolar Device Market .................................................................. 233

10.3.4 Monopolar Electrode Market ............................................................................................ 235

10.3.5 Electrosurgical Generator Market ..................................................................................... 237

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10.4 DRIVERS AND LIMITERS ........................................................................................................ 239

10.4.1 Market Drivers .................................................................................................................. 239

10.4.2 Market Limiters ................................................................................................................. 239

10.5 COMPETITIVE ANALYSIS ....................................................................................................... 241

ULTRASONIC DEVICE MARKET ........................................................................................ 244

11.1 INTRODUCTION ...................................................................................................................... 244

11.2 MARKET OVERVIEW .............................................................................................................. 246


11.3.1 Total Ultrasonic Device Market ........................................................................................ 250

11.3.2 Reusable Ultrasonic Device Market .................................................................................. 252

11.3.3 Reposable Ultrasonic Device Market ................................................................................ 254

11.3.4 Ultrasonic Hardware Market ............................................................................................. 257


11.4.1 Market Drivers .................................................................................................................. 259

11.4.2 Market Limiters ................................................................................................................. 259


HAND-ASSISTED DEVICE MARKET .................................................................................. 265

12.1 INTRODUCTION ...................................................................................................................... 265



12.3.1 Market Drivers .................................................................................................................. 268

12.3.2 Market Limiters ................................................................................................................. 268


CLOSURE DEVICE MARKET ............................................................................................... 273

13.1 INTRODUCTION ...................................................................................................................... 273

13.2 MARKET OVERVIEW .............................................................................................................. 274


13.3.1 Stapler (Endocutter and Endostapler) Market ................................................................... 278

13.3.2 Endosuturing Device Market ............................................................................................ 281

13.3.3 Total Clip Applier Market ................................................................................................. 283

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13.3.3.1 10 mm Disposable Clip Applier Market ............................................................................... 286

13.3.3.2 5 mm Disposable Clip Applier Market ................................................................................. 288

13.3.3.3 10 mm Reposable Clip Applier Market ................................................................................ 290


13.4.1 Market Drivers .................................................................................................................. 292

13.4.2 Market Limiters ................................................................................................................. 293


GASTRIC BAND MARKET .................................................................................................... 297

14.1 INTRODUCTION ...................................................................................................................... 297

14.2 POPULATION AT RISK ............................................................................................................ 298



14.4.1 Market Drivers .................................................................................................................. 301

14.4.2 Market Limiters ................................................................................................................. 301


POWERED MORCELLATOR MARKET ............................................................................. 305

15.1 INTRODUCTION ...................................................................................................................... 305

15.2 MARKET OVERVIEW .............................................................................................................. 307


15.3.1 Total Powered Morcellator Market ................................................................................... 311

15.3.2 Disposable Powered Morcellator Market .......................................................................... 313

15.3.3 Reposable Powered Morcellator Market ........................................................................... 316


15.4.1 Market Drivers .................................................................................................................. 318

15.4.2 Market Limiters ................................................................................................................. 318


FEMALE STERILIZATION DEVICE MARKET ................................................................ 325

16.1 INTRODUCTION ...................................................................................................................... 325

16.2 MARKET OVERVIEW .............................................................................................................. 326


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16.3.1 Total Female Sterilization Device Market ........................................................................ 329

16.3.2 Total Mechanical Sterilization Device Market ................................................................. 331

16.3.2.1 Ligation Clip Market ........................................................................................................... 333

16.3.2.2 Ligation Band Market .......................................................................................................... 335

16.3.3 Transcervical Implant Market ........................................................................................... 337

16.4 FEMALE STERILIZATION PROCEDURES .................................................................................. 340

16.4.1 Female Sterilization Unit and Procedure Discrepancy ..................................................... 340

16.4.2 Non-Mechanical Female Sterilization Procedures ............................................................ 340

16.4.2.1 Pomeroy Technique ............................................................................................................. 340

16.4.2.2 Parkland Technique ............................................................................................................. 340


16.5.1 Market Drivers .................................................................................................................. 341

16.5.2 Market Limiters ................................................................................................................. 341


ABBREVIATIONS .................................................................................................................... 346

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LIST OF FIGURES

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L I S T O F F I G U R E S

Figure 3-1: Laparoscopic Device Market by Segment, U.S., 2011 – 2021 (US$M) (1 of 2) ..................... 25

Figure 3-2: Laparoscopic Device Market by Segment, U.S., 2011 – 2021 (US$M) (2 of 2) ..................... 25

Figure 3-3: Laparoscopic Device Market Growth by Segment, U.S., 2011 – 2021 (1 of 2) ...................... 29

Figure 3-4: Laparoscopic Device Market Growth by Segment, U.S., 2011 – 2021 (2 of 2) ...................... 29

Figure 3-5: Drivers and Limiters, Laparoscopic Device Market, U.S., 2014 ............................................ 33

Figure 3-6: Leading Competitors, Laparoscopic Device Market, U.S., 2014 (1 of 2) ............................... 37

Figure 3-7: Leading Competitors, Laparoscopic Device Market, U.S., 2011 – 2021 (2 of 2) ................... 38

Figure 3-8: Herfindahl Index, Laparoscopic Device Market, U.S., 2014 ................................................. 40

Figure 4-1: Laparoscopic Procedure Numbers by Type, U.S., 2011 – 2021 (1 of 2) ................................ 51

Figure 4-2: Laparoscopic Procedure Numbers by Type, U.S., 2011 – 2021 (2 of 2) ................................ 52

Figure 4-3: Open Procedure Numbers by Type, U.S., 2011 – 2021 (1 of 2)............................................. 54

Figure 4-4: Open Procedures by Type, U.S., 2011 – 2021 (2 of 2) .......................................................... 55

Figure 4-5: Open and Laparoscopic Procedure Numbers by Type, U.S., 2011 – 2021 (1 of 2) ................ 57

Figure 4-6: Open and Laparoscopic Procedure Numbers by Type, U.S., 2011 – 2021 (2 of 2) ................ 58

Figure 4-7: Laparoscopic Procedure Numbers by State, U.S., 2010 – 2013 (1 of 2) ................................ 61

Figure 4-8: Laparoscopic Procedure Numbers by State, U.S., 2010 – 2013 (2 of 2) ................................ 62

Figure 4-9: Gastric Band Procedure Numbers by Placement/Removal, U.S., 2011 – 2021 ...................... 64

Figure 4-10: Outpatient Gastric Band Procedure Numbers by Placement/Removal, U.S., 2011 – 2021 ... 65

Figure 4-11: Inpatient Gastric Band Procedure Numbers by Placement/Removal, U.S., 2011 – 2021 ...... 66

Figure 4-12: Total Gastric Bypass Procedure Numbers, U.S., 2011 – 2021 ............................................. 68

Figure 4-13: Outpatient Gastric Bypass Procedure Numbers, U.S., 2011 – 2021 ..................................... 69

Figure 4-14: Inpatient Gastric Bypass Procedure Numbers, U.S., 2011 – 2021 ....................................... 70

Figure 4-15: Sleeve Gastrectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ........... 72

Figure 4-16: Outpatient Sleeve Gastrectomy Procedure Numbers by Open/Laparoscopic, U.S.,

2011 – 2021 ......................................................................................................................................... 73

Figure 4-17: Inpatient Sleeve Gastrectomy Procedure Numbers by Open/Laparoscopic, U.S.,

2011 – 2021 ......................................................................................................................................... 74

Figure 4-18: Anti-Reflux Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ....................... 76

Figure 4-19: Outpatient Anti-Reflux Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ...... 77

Figure 4-20: Inpatient Anti-Reflux Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ........ 78

LIST OF FIGURES

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Figure 4-21: Colectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ........................ 80

Figure 4-22: Outpatient Colectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ....... 81

Figure 4-23: Inpatient Colectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .......... 82

Figure 4-24: Cholecystectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ............... 84

Figure 4-25: Outpatient Cholecystectomy Procedure Numbers by Open/Laparoscopic, U.S.,

2011 – 2021 ......................................................................................................................................... 85

Figure 4-26: Inpatient Cholecystectomy Procedure Numbers by Open/Laparoscopic, U.S.,

2011 – 2021 ......................................................................................................................................... 86

Figure 4-27: Nephrectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .................... 88

Figure 4-28: Outpatient Nephrectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ... 89

Figure 4-29: Inpatient Nephrectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ...... 90

Figure 4-30: Appendectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .................. 92

Figure 4-31: Outpatient Appendectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 . 93

Figure 4-32: Inpatient Appendectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ... 94

Figure 4-33: Adrenalectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .................. 96

Figure 4-34: Outpatient Adrenalectomy Procedure Numbers by Open/Laparoscopic, U.S.,

2011 – 2021 ......................................................................................................................................... 97

Figure 4-35: Inpatient Adrenalectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ... 98

Figure 4-36: Hernia Repair Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .................. 101

Figure 4-37: Outpatient Hernia Repair Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 . 102

Figure 4-38: Inpatient Hernia Repair Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ... 103

Figure 4-39: Hysterectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .................. 105

Figure 4-40: Outpatient Hysterectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 . 106

Figure 4-41: Inpatient Hysterectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ... 107

Figure 4-42: Female Sterilization Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ........ 109

Figure 5-1: Laparoscope Market by Segment, U.S., 2011 – 2021 (US$M) ............................................ 113

Figure 5-2: Total Laparoscope Market, U.S., 2011 – 2021 .................................................................... 116

Figure 5-3: Rod Lens Laparoscope Market, U.S., 2011 – 2021 ............................................................. 120

Figure 5-4: Video Laparoscope Market, U.S., 2011 – 2021 .................................................................. 122

Figure 5-5: Drivers and Limiters, Laparoscope Market, U.S., 2014 ...................................................... 124

Figure 5-6: Leading Competitors, Laparoscope Market, U.S., 2014 ...................................................... 127

Figure 6-1: Access Device Market by Segment, U.S., 2011 – 2021 (US$M) ......................................... 131

Figure 6-2: Total Access Device Market, U.S., 2011 – 2021 ................................................................. 133

Figure 6-3: Total Trocar Market, U.S., 2011 – 2021 ............................................................................. 136

Figure 6-4: Reusable Trocar Market, U.S., 2011 – 2021 ....................................................................... 139

LIST OF FIGURES

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Figure 6-5: Disposable Trocar Market, U.S., 2011 – 2021 .................................................................... 141

Figure 6-6: Reposable Trocar Market, U.S., 2011 – 2021 ..................................................................... 143

Figure 6-7: Single Port Access Device Market, U.S., 2011 – 2021........................................................ 145

Figure 6-8: Drivers and Limiters, Access Device Market, U.S., 2014 ................................................... 147

Figure 6-9: Leading Competitors, Access Device Market, U.S., 2014 ................................................... 150

Figure 7-1: Hand Instrument Market by Segment, U.S., 2011 – 2021 (US$M) ...................................... 154

Figure 7-2: Total Hand Instrument Market, U.S., 2011 – 2021 ............................................................. 158

Figure 7-3: Reusable Hand Instrument Market, U.S., 2011 – 2021 ....................................................... 160

Figure 7-4: Disposable Hand Instrument Market, U.S., 2011 – 2021 .................................................... 162

Figure 7-5: Reposable Hand Instrument Market, U.S., 2011 – 2021 ...................................................... 164

Figure 7-6: Articulating Hand Instrument Market, U.S., 2011 – 2021 ................................................... 166

Figure 7-7: Drivers and Limiters, Hand Instrument Market, U.S., 2014 ................................................ 168

Figure 7-8: Leading Competitors, Hand Instrument Market, U.S., 2014 ................................................ 172

Figure 8-1: Insufflation Device Market by Segment, U.S., 2011 – 2021 (US$M) .................................. 177

Figure 8-2: Total Insufflation Device Market, U.S., 2011 – 2021 .......................................................... 180

Figure 8-3: Insufflator Market, U.S., 2011 – 2021 ................................................................................ 182

Figure 8-4: Veress Needle Market, U.S., 2011 – 2021 .......................................................................... 185

Figure 8-5: Total Insufflator Tubing Market, U.S., 2011 – 2021 ........................................................... 187

Figure 8-6: Standard Insufflator Tubing Market, U.S., 2011 – 2021...................................................... 189

Figure 8-7: Heated Insufflator Tubing Market, U.S., 2011 – 2021 ........................................................ 191

Figure 8-8: Drivers and Limiters, Insufflation Device Market, U.S., 2014 ............................................ 193

Figure 8-9: Leading Competitors, Insufflation Device Market, U.S., 2014 ............................................ 196

Figure 9-1: Suction-Irrigation Device Market by Segment, U.S., 2011 – 2021 (US$M) ........................ 201

Figure 9-2: Total Suction-Irrigation Device Market, U.S., 2011 – 2021 ................................................ 203

Figure 9-3: Total Disposable Kit Market, U.S., 2011 – 2021 ................................................................ 206

Figure 9-4: Battery-Powered Disposable Kit Market, U.S., 2011 – 2021............................................... 207

Figure 9-5: Hybrid Disposable Kit Market, U.S., 2011 – 2021 .............................................................. 209

Figure 9-6: Capital Equipment Disposable Kit Market, U.S., 2011 – 2021 ............................................ 211

Figure 9-7: Total Reusable Tip Market, U.S., 2011 – 2021 ................................................................... 214

Figure 9-8: Electrocautery Reusable Tip Market, U.S., 2011 – 2021 ..................................................... 216

Figure 9-9: Standard Reusable Tip Market, U.S., 2011 – 2021 ............................................................. 218

Figure 9-10: Suction-Irrigation Pump Market, U.S., 2011 – 2021 ......................................................... 220

Figure 9-11: Drivers and Limiters, Suction-Irrigation Device Market, U.S., 2014 ................................. 221

Figure 9-12: Leading Competitors, Suction-Irrigation Device Market, U.S., 2014 ................................ 223

Figure 10-1: Direct Energy Device Market by Segment, U.S., 2011 – 2021 (US$M) ............................ 227

LIST OF FIGURES

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Figure 10-2: Total Direct Energy Device Market, U.S., 2011 – 2021 .................................................... 230

Figure 10-3: Reusable Standard Bipolar Device Market, U.S., 2011 – 2021.......................................... 232

Figure 10-4: Disposable Advanced Bipolar Device Market, U.S., 2011 – 2021 ..................................... 234

Figure 10-5: Monopolar Electrode Market, U.S., 2011 – 2021 .............................................................. 236

Figure 10-6: Electrosurgical Generator Market, U.S., 2011 – 2021 ....................................................... 238

Figure 10-7: Drivers and Limiters, Direct Energy Device Market, U.S., 2014 ....................................... 240

Figure 10-8: Leading Competitors, Direct Energy Device Market, U.S., 2014 ...................................... 243

Figure 11-1: Ultrasonic Device Market by Segment, U.S., 2011 – 2021 (US$M) .................................. 247

Figure 11-2: Total Ultrasonic Device Market, U.S., 2011 – 2021.......................................................... 250

Figure 11-3: Reusable Ultrasonic Device Market, U.S., 2011 – 2021 .................................................... 253

Figure 11-4: Reposable Ultrasonic Device Market, U.S., 2011 – 2021 .................................................. 255

Figure 11-5: Ultrasonic Hardware Market, U.S., 2011 – 2021 .............................................................. 258

Figure 11-6: Drivers and Limiters, Ultrasonic Device Market, U.S., 2014 ............................................ 260

Figure 11-7: Leading Competitors, Ultrasonic Device Market, U.S., 2014 ............................................ 262

Figure 12-1: Hand-Assisted Device Market, U.S., 2011 – 2021 ............................................................ 267

Figure 12-2: Drivers and Limiters, Hand-Assisted Device Market, U.S., 2014 ...................................... 269

Figure 12-3: Leading Competitors, Hand-Assisted Device Market, U.S., 2014 ..................................... 271

Figure 13-1: Closure Device Market by Segment, U.S., 2011 – 2021 (US$M) ...................................... 275

Figure 13-2: Stapler (Endocutter and Endostapler) Market, U.S., 2011 – 2021 (US$M) ........................ 279

Figure 13-3: Endosuturing Device Market, U.S., 2011 – 2021 .............................................................. 282

Figure 13-4: Total Clip Applier Market, U.S., 2011 – 2021 .................................................................. 284

Figure 13-5: 10 mm Disposable Clip Applier Market, U.S., 2011 – 2021 ............................................. 287

Figure 13-6: 5 mm Disposable Clip Applier Market, U.S., 2011 – 2021 ............................................... 289

Figure 13-7: 10 mm Reposable Clip Applier Market, U.S., 2011 – 2021............................................... 291

Figure 13-8: Drivers and Limiters, Closure Device Market, U.S., 2014 ................................................ 293

Figure 13-9: Leading Competitors, Closure Device Market, U.S., 2014 ................................................ 295

Figure 14-1: Gastric Band Market, U.S., 2011 – 2021 .......................................................................... 300

Figure 14-2: Drivers and Limiters, Gastric Band Market, U.S., 2014 .................................................... 302

Figure 14-3: Leading Competitors, Gastric Band Market, U.S., 2014 ................................................... 304

Figure 15-1: Powered Morcellator Device Market by Segment, U.S., 2011 – 2021 (US$M) ................. 309

Figure 15-2: Total Powered Morcellator Market, U.S., 2011 – 2021 ..................................................... 312

Figure 15-3: Disposable Powered Morcellator Market, U.S., 2011 – 2021 ............................................ 314

Figure 15-4: Reposable Powered Morcellator Market, U.S., 2011 – 2021 ............................................. 317

Figure 15-5: Drivers and Limiters, Powered Morcellator Device Market, U.S., 2014 ............................ 319

Figure 15-6: Leading Competitors, Powered Morcellator Market, U.S., 2014 ....................................... 322

LIST OF FIGURES

© iData Research Inc., 2015 xv

Figure 16-1: Female Sterilization Device Market by Segment, U.S., 2011 – 2021 (US$M) ................... 327

Figure 16-2: Total Female Sterilization Device Market, U.S., 2011 – 2021 ........................................... 329

Figure 16-3: Total Mechanical Sterilization Device Market, U.S., 2011 – 2021 .................................... 332

Figure 16-4: Ligation Clip Market, U.S., 2011 – 2021 .......................................................................... 334

Figure 16-5: Ligation Band Market, U.S., 2011 – 2021 ........................................................................ 336

Figure 16-6: Transcervical Implant Market, U.S., 2011 – 2021 ............................................................. 338

Figure 16-7: Drivers and Limiters, Female Sterilization Device Market, U.S., 2014 ............................. 342

Figure 16-8: Leading Competitors, Female Sterilization Device Market, U.S., 2014 ............................. 344

LIST OF FIGURES

© iData Research Inc., 2015 xvi

LIST OF CHARTS

© iData Research Inc., 2015 xvii

L I S T O F C H A R T S

Chart 1-1: Laparoscopic Device Market, U.S., 2011 – 2021 ..................................................................... 1

Chart 1-2: Growth for Selected Segments, Laparoscopic Device Market, U.S., 2011 – 2021 ..................... 2

Chart 1-3: Growth by Segment, Laparoscopic Procedures, U.S., 2011 – 2021 .......................................... 3

Chart 1-4: Average Selling Prices by Segment, Laparoscope Market, U.S., 2012 – 2014 .......................... 4

Chart 1-5: Select Segments, Access Device Market, U.S., 2014 ............................................................... 5

Chart 1-6: Select Segments, Direct Energy Device Market, U.S., 2011 – 2014 ......................................... 6

Chart 1-7: Ultrasonic Device Market by Segment, U.S., 2012 – 2014 ....................................................... 7

Chart 1-8: Growth Rates by Segment, Closure Device Market, U.S., 2013 and 2014 ................................ 8

Chart 1-9: Powered Morcellator Device Market by Segment, U.S., 2011 – 2014 ...................................... 9

Chart 1-10: Leading Competitors, Laparoscopic Device Market U.S., 2014 ............................................ 10

Chart 3-1: Laparoscopic Device Market by Segment, U.S., 2011 – 2021 ................................................ 26

Chart 3-2: Laparoscopic Device Market Breakdown, 2014 ..................................................................... 27

Chart 3-3: Laparoscopic Device Market Breakdown, 2021 ..................................................................... 27

Chart 3-4: Laparoscopic Device Market Growth by Segment, U.S., 2011 – 2021 .................................... 30

Chart 3-5: Leading Competitors, Laparoscopic Device Market, U.S., 2014 ............................................ 39

Chart 3-6: Herfindahl Index, Laparoscopic Device Market, U.S., 2014 ................................................... 41

Chart 4-1: Laparoscopic Procedure Numbers by Type, U.S., 2011 – 2021 .............................................. 53

Chart 4-2: Open Procedure Numbers by Type, U.S., 2011 – 2021 .......................................................... 56

Chart 4-3: Open and Laparoscopic Procedure Numbers by Type, U.S., 2011 – 2021 .............................. 59

Chart 4-4: Gastric Band Procedure Numbers by Placement/Removal, U.S., 2011 – 2021 ....................... 64

Chart 4-5: Outpatient Gastric Band Procedure Numbers by Placement/Removal, U.S., 2011 – 2021 ....... 65

Chart 4-6: Inpatient Gastric Band Procedure Numbers by Placement/Removal, U.S., 2011 – 2021 ......... 66

Chart 4-7: Total Gastric Bypass Procedure Numbers, U.S., 2011 – 2021 ................................................ 68

Chart 4-8: Outpatient Gastric Bypass Procedure Numbers, U.S., 2011 – 2021 ........................................ 69

Chart 4-9: Inpatient Gastric Bypass Procedure Numbers, U.S., 2011 – 2021 ........................................... 70

Chart 4-10: Sleeve Gastrectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ............ 72

Chart 4-11: Outpatient Sleeve Gastrectomy Procedure Numbers by Open/Laparoscopic, U.S.,

2011 – 2021 ......................................................................................................................................... 73

Chart 4-12: Inpatient Sleeve Gastrectomy Procedure Numbers by Open/Laparoscopic, U.S.,

2011 – 2021 ......................................................................................................................................... 74

LIST OF CHARTS

© iData Research Inc., 2015 xviii

Chart 4-13: Anti-Reflux Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ........................ 76

Chart 4-14: Outpatient Anti-Reflux Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ....... 77

Chart 4-15: Inpatient Anti-Reflux Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .......... 78

Chart 4-16: Colectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .......................... 80

Chart 4-17: Outpatient Colectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ......... 81

Chart 4-18: Inpatient Colectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ........... 82

Chart 4-19: Cholecystectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ................ 84

Chart 4-20: Outpatient Cholecystectomy Procedure Numbers by Open/Laparoscopic, U.S.,

2011 – 2021 ......................................................................................................................................... 85

Chart 4-21: Inpatient Cholecystectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .. 86

Chart 4-22: Nephrectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ...................... 88

Chart 4-23: Outpatient Nephrectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ..... 89

Chart 4-24: Inpatient Nephrectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ....... 90

Chart 4-25: Appendectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ................... 92

Chart 4-26: Outpatient Appendectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .. 93

Chart 4-27: Inpatient Appendectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ..... 94

Chart 4-28: Adrenalectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ................... 96

Chart 4-29: Outpatient Adrenalectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .. 97

Chart 4-30: Inpatient Adrenalectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ..... 98

Chart 4-31: Hernia Repair Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ................... 101

Chart 4-32: Outpatient Hernia Repair Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .. 102

Chart 4-33: Inpatient Hernia Repair Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ..... 103

Chart 4-34: Hysterectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ................... 105

Chart 4-35: Outpatient Hysterectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .. 106

Chart 4-36: Inpatient Hysterectomy Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 ..... 107

Chart 4-37: Female Sterilization Procedure Numbers by Open/Laparoscopic, U.S., 2011 – 2021 .......... 109

Chart 5-1: Laparoscope Market by Segment, U.S., 2011 – 2021 ........................................................... 114

Chart 5-2: Laparoscope Market Breakdown, U.S., 2014 ....................................................................... 115

Chart 5-3: Laparoscope Market Breakdown, U.S., 2021 ....................................................................... 115

Chart 5-4: Total Laparoscope Market, U.S., 2011 – 2021 ..................................................................... 117

Chart 5-5: Rod Lens Laparoscope Market, U.S., 2011 – 2021 .............................................................. 120

Chart 5-6: Video Laparoscope Market, U.S., 2011 – 2021 .................................................................... 122

Chart 5-7: Leading Competitors, Laparoscope Market, U.S., 2014 ....................................................... 128

Chart 6-1: Access Device Market by Segment, U.S., 2011 – 2021 ........................................................ 131

Chart 6-2: Access Device Market Breakdown, U.S., 2014 .................................................................... 132

LIST OF CHARTS

© iData Research Inc., 2015 xix

Chart 6-3: Access Device Market Breakdown, U.S., 2021 .................................................................... 132

Chart 6-4: Total Access Device Market, U.S., 2011 – 2021 .................................................................. 134

Chart 6-5: Total Trocar Market, U.S., 2011 – 2021 .............................................................................. 136

Chart 6-6: Trocar Market Breakdown, U.S., 2014 ................................................................................ 137

Chart 6-7: Trocar Market Breakdown, U.S., 2021 ................................................................................ 137

Chart 6-8: Reusable Trocar Market, U.S., 2011 – 2021......................................................................... 139

Chart 6-9: Disposable Trocar Market, U.S., 2011 – 2021...................................................................... 141

Chart 6-10: Reposable Trocar Market, U.S., 2011 – 2021 ..................................................................... 143

Chart 6-11: Single Port Access Device Market, U.S., 2011 – 2021 ....................................................... 145

Chart 6-12: Leading Competitors, Access Device Market, U.S., 2014 .................................................. 150

Chart 7-1: Hand Instrument Market by Segment, U.S., 2011 – 2021 ..................................................... 155

Chart 7-2: Hand Instrument Market Breakdown, U.S., 2014 ................................................................. 156

Chart 7-3: Hand Instrument Market Breakdown, U.S., 2021 ................................................................. 156

Chart 7-4: Total Hand Instrument Market, U.S., 2011 – 2021 ............................................................... 158

Chart 7-5: Reusable Hand Instrument Market, U.S., 2011 – 2021 ......................................................... 160

Chart 7-6: Disposable Hand Instrument Market, U.S., 2011 – 2021 ...................................................... 162

Chart 7-7: Reposable Hand Instrument Market, U.S., 2011 – 2021 ....................................................... 164

Chart 7-8: Articulating Hand Instrument Market, U.S., 2011 – 2021 .................................................... 166

Chart 7-9: Leading Competitors, Hand Instrument Market, U.S., 2014 ................................................. 173

Chart 8-1: Insufflation Device Market by Segment, U.S., 2011 – 2021 ................................................. 177

Chart 8-2: Insufflation Device Market Breakdown, U.S., 2014 ............................................................. 178

Chart 8-3: Insufflation Device Market Breakdown, U.S., 2021 ............................................................. 178

Chart 8-4: Total Insufflation Device Market, U.S., 2011 – 2021 ........................................................... 180

Chart 8-5: Insufflator Market, U.S., 2011 – 2021 ................................................................................. 183

Chart 8-6: Veress Needle Market, U.S., 2011 – 2021 ........................................................................... 185

Chart 8-7: Total Insufflator Tubing Market, U.S., 2011 – 2021 ............................................................. 187

Chart 8-8: Standard Insufflator Tubing Market, U.S., 2011 – 2021 ....................................................... 189

Chart 8-9: Heated Insufflator Tubing Market, U.S., 2011 – 2021 .......................................................... 191

Chart 8-10: Leading Competitors, Insufflation Device Market, U.S., 2014 ........................................... 197

Chart 9-1: Suction-Irrigation Device Market by Segment, U.S., 2011 – 2021 ....................................... 201

Chart 9-2: Suction-Irrigation Device Market Breakdown, U.S., 2014 ................................................... 202

Chart 9-3: Suction-Irrigation Device Market Breakdown, U.S., 2021 ................................................... 202

Chart 9-4: Total Suction-Irrigation Device Market, U.S., 2011 – 2021 ................................................. 204

Chart 9-5: Total Disposable Kit Market, U.S., 2011 – 2021 .................................................................. 206

Chart 9-6: Battery-Powered Disposable Kit Market, U.S., 2011 – 2021 ................................................ 208

LIST OF CHARTS

© iData Research Inc., 2015 xx

Chart 9-7: Hybrid Disposable Kit Market, U.S., 2011 – 2021 ............................................................... 210

Chart 9-8: Capital Equipment Disposable Kit Market, U.S., 2011 – 2021 ............................................. 212

Chart 9-9: Total Reusable Tip Market, U.S., 2011 – 2021 .................................................................... 214

Chart 9-10: Electrocautery Reusable Tip Market, U.S., 2011 – 2021 .................................................... 216

Chart 9-11: Standard Reusable Tip Market, U.S., 2011 – 2021 ............................................................. 218

Chart 9-12: Suction-Irrigation Pump Market, U.S., 2011 – 2021........................................................... 220

Chart 9-13: Leading Competitors, Suction-Irrigation Device Market, U.S., 2014 .................................. 224

Chart 10-1: Direct Energy Device Market by Segment, U.S., 2011 – 2021 ........................................... 227

Chart 10-2: Direct Energy Device Market Breakdown, U.S., 2014 ....................................................... 228

Chart 10-3: Direct Energy Device Market Breakdown, U.S., 2021 ....................................................... 228

Chart 10-4: Total Direct Energy Device Market, U.S., 2011 – 2021 ..................................................... 230

Chart 10-5: Reusable Standard Bipolar Device Market, U.S., 2011 – 2021 ........................................... 232

Chart 10-6: Disposable Advanced Bipolar Device Market, U.S., 2011 – 2021 ...................................... 234

Chart 10-7: Monopolar Electrode Market, U.S., 2011 – 2021 ............................................................... 236

Chart 10-8: Electrosurgical Generator Market, U.S., 2011 – 2021 ........................................................ 238

Chart 10-9: Leading Competitors, Direct Energy Device Market, U.S., 2014 ........................................ 243

Chart 11-1: Ultrasonic Device Market by Segment, U.S., 2011 – 2021 ................................................. 248

Chart 11-2: Ultrasonic Device Market Breakdown, U.S., 2014 ............................................................. 249

Chart 11-3: Ultrasonic Device Market Breakdown, U.S., 2021 ............................................................. 249

Chart 11-4: Total Ultrasonic Device Market, U.S., 2011 – 2021 ........................................................... 251

Chart 11-5: Reusable Ultrasonic Device Market, U.S., 2011 – 2021 ..................................................... 253

Chart 11-6: Reposable Ultrasonic Device Market, U.S., 2011 – 2021 ................................................... 256

Chart 11-7: Ultrasonic Hardware Market, U.S., 2011 – 2021 ................................................................ 258

Chart 11-8: Leading Competitors, Ultrasonic Device Market, U.S., 2014 ............................................. 263

Chart 12-1: Hand-Assisted Device Market, U.S., 2011 – 2021 ............................................................. 267

Chart 12-2: Leading Competitors, Hand-Assisted Device Market, U.S., 2014 ....................................... 271

Chart 13-1: Closure Device Market by Segment, U.S., 2011 – 2021 ..................................................... 276

Chart 13-2: Closure Device Market Breakdown, U.S., 2014 ................................................................. 277

Chart 13-3: Closure Device Market Breakdown, U.S., 2021 ................................................................. 277

Chart 13-4: Stapler (Endocutter and Endostapler) Market, U.S., 2011 – 2021 ....................................... 280

Chart 13-5: Endosuturing Device Market, U.S., 2011 – 2021 ............................................................... 282

Chart 13-6: Total Clip Applier Market, U.S., 2011 – 2021.................................................................... 285

Chart 13-7: 10 mm Disposable Clip Applier Market, U.S., 2011 – 2021 ............................................... 287

Chart 13-8: 5 mm Disposable Clip Applier Market, U.S., 2011 – 2021 ................................................. 289

Chart 13-9: 10 mm Reposable Clip Applier Market, U.S., 2011 – 2021 ................................................ 291

LIST OF CHARTS

© iData Research Inc., 2015 xxi

Chart 13-10: Leading Competitors, Closure Device Market, U.S., 2014 ............................................... 296

Chart 14-1: Gastric Band Market, U.S., 2011 – 2021 ............................................................................ 300

Chart 14-2: Leading Competitors, Gastric Band Market, U.S., 2014 ..................................................... 304

Chart 15-1: Powered Morcellator Market by Segment, U.S., 2011 – 2021 ............................................ 309

Chart 15-2: Powered Morcellator Device Market Breakdown, U.S., 2014............................................. 310

Chart 15-3: Powered Morcellator Device Market Breakdown, U.S., 2021............................................. 310

Chart 15-4: Total Powered Morcellator Market, U.S., 2011 – 2021 ...................................................... 312

Chart 15-5: Disposable Powered Morcellator Market, U.S., 2011 – 2021 ............................................. 315

Chart 15-6: Reposable Powered Morcellator Market, U.S., 2011 – 2021............................................... 317

Chart 15-7: Leading Competitors, Powered Morcellator Device Market, U.S., 2014 ............................. 323

Chart 16-1: Female Sterilization Device Market by Segment, U.S., 2011 – 2021 .................................. 327

Chart 16-2: Female Sterilization Device Market Breakdown, U.S., 2014 .............................................. 328

Chart 16-3: Female Sterilization Device Market Breakdown, U.S., 2021 .............................................. 328

Chart 16-4: Total Female Sterilization Device Market, U.S., 2011 – 2021 ........................................... 330

Chart 16-5: Total Mechanical Sterilization Device Market, U.S., 2011 – 2021...................................... 332

Chart 16-6: Ligation Clip Market, U.S., 2011 – 2021 ........................................................................... 334

Chart 16-7: Ligation Band Market, U.S., 2011 – 2021 .......................................................................... 336

Chart 16-8: Transcervical Implant Market, U.S., 2011 – 2021 .............................................................. 339

Chart 16-9: Leading Competitors, Female Sterilization Device Market, U.S., 2014 .............................. 345

LIST OF CHARTS

© iData Research Inc., 2015 xxii

U S LAPAROSCOPIC DEVICE MARKET OVERVIEW

© iData Research Inc., 2015 23

3

U. S. L A PA RO S C O P I C D E V I C E M A R K E T OV E RV I E W

3.1 Introduction

Laparoscopy has been practiced for almost a century. It is a minimally invasive surgical technique in

which operations in the abdominal or pelvic cavities are performed through small incisions that are usually

between 5 mm to 15 mm. Laparoscopic access devices, or trocars, facilitate the insertion of various

instruments into the patients abdomen, allowing the surgeon to carry out the procedure. Laparoscopes are

inserted through a port of access, often at the site of the umbilicus or subxyphoid, and are equipped to

illuminate and display the peritoneal cavity to allow the surgical team to perform abdominal and pelvic

surgeries. Depending on the type of procedure, the number of incisions will vary; the average is three to

four incisions per procedure. These sites provide entrance for other laparoscopic devices to enter the body

cavity. Various hand instruments such as scissors, dissectors and graspers are used for manipulating and

maneuvering organs and tissue. Alternative devices using direct energy and ultrasonic energy may be used

for grasping, cutting and coagulating the tissue.



3.2 Market Overview

The U.S. laparoscopic device market includes laparoscopes, access devices, hand instruments, insufflation

devices, suction-irrigation devices, direct energy devices, ultrasonic devices, hand-assisted devices,

closure devices, gastric bands, powered morcellators and female sterilization devices. An in-depth

evaluation of procedure numbers is also included in this report that compares trends between the open and

laparoscopic approaches in both inpatient and outpatient settings.



3.3 Trend Analysis by Segment

In 2014, the fastest growing segments of the U.S. market for laparoscopic devices were the female

sterilization and hand-assisted device markets, which grew by X% and X% over the previous year,

respectively. These segments were only capable of achieving such high growth because of their small size.



3.4 Drivers and Limiters

3.4.1 Market Drivers

Value-Added Services

Value-added services provide an opportunity for companies looking to increase their bottom line in

markets that are saturated with alternative products. For example, Covidien’s Valleylab™ Exchange

Service Agent software is used to remotely download and install software for their energy-based devices.

These optional extras will allow companies to ensure that their products maintain a competitive advantage

over other devices in the market.

3.4.2 Market Limiters

Capital Budget Constraints

Most hospitals operate on limited capital budgets. This has limited their ability to purchase new and

improved equipment. Budget constraints drive hospitals to either continue using older equipment, or opt

into replacement plans.





3.5 Competitive Analysis

Ethicon

In 2014, the leading competitor in the U.S. market for laparoscopic devices was Ethicon, with a market

share of X%. This company relies on their well-known reputation for high-quality products, especially in

the ultrasonic and access device markets. Ethicon generally prices its products above the market average,

avoiding pricing wars altogether. The company led the ultrasonic segments and also competed in the

segments for access, hand instrument, insufflation, direct energy, hand-assisted and closure devices, as

well as that of gastric bands.







3.7 Mergers and Acquisitions

Becton Dickinson Acquired CareFusion

On October 5th, 2014, Becton Dickinson acquired CareFusion for $X. The acquisition will allow Becton

Dickinson to offer a wide variety of smart devices and patient monitoring equipment that will facilitate

integrated medical management. The ultimate goal of this acquisition was to improve patient care while

keeping health care costs to a minimum.





3.8 Market Trends

3.8.1 Full Product Lines Through a Single Vendor

Purchasing a full line of laparoscopic products from a single vendor provides the buyer with a number of

advantages over purchasing from multiple vendors. Buyers are able to negotiate better prices when

purchasing a number of different devices as opposed to a single device. Contract length can also be

altered, allowing end-users to receive a greater discount in exchange for longer terms. In addition, the end-

user’s needs for repair and refurbishing are handled by a single company, thus adding to the convenience

of using a single vendor.

3.8.2 Preference With Surgical Subspecialty

Particular surgical sub-specialties may have preferences for different device types. For example,

gastrointestinal surgeons tend to prefer hand-assisted laparoscopic surgery (HALS). The surgeon is then

able to hand-palpate the tissue and more finely discern the state of disease. These preferential differences

may be fostered through training and experience with particular device types.

3.8.3 Supplier Procedure Promotion

Covidien, Ethicon, Karl Storz and other notable companies are influential sources that impact the choice

of medical intervention for alternative laparoscopic procedures, including hand-assisted laparoscopic

procedures and obesity intervention. Companies often devote resources to offer surgeon training at a low

cost with the purchase of an advertised product. When training is readily available, surgeons are more

likely to take on new technology with expected improved patient outcomes.

3.8.4 Multifunctional Devices

Laparoscopic procedures often require the use of several different instruments and devices. The removal

and insertion of various devices increases operative time. Devices that perform more than one function are

preferred, as they are more convenient for the surgeon and reduce the time otherwise required to exchange

devices.



3.9 Emerging Technologies

3.9.1 Robotics in Laparoscopic Surgery

Robotics have been used in surgery for almost three decades. The technology has advanced to the point

that laparoscopic robotic devices, such as Intuitive Surgical’s Da Vinci® robot, have been developed and

sold in the market since 2000. Common laparoscopic surgeries give the surgeon a limited two-dimensional

view of the operative field. Robotics overcomes this limitation by allowing three-dimensional

visualization via 3D visualization technology. The robotic arm is controlled by the surgeon who can

operate it remotely and does not have to be in the same room as the patient.

3.9.2 Surgical Smoke Evacuation Systems

Surgical smoke is both hazardous to the medical professionals in the operating room and can obstruct the

surgeon’s view of the operative field. When surgical instruments cut tissue, the debris can contain

contaminants and biohazards. Inhaled “plume,” or noxious airborne contaminants, can cause irritation,

dizziness, nausea or even carcinogenic cell changes. The smoke can hinder the effectiveness of

laparoscopic devices, and thus companies are introducing evacuation systems, such as Buffalo Filter’s

LapEvac® Surgical Smoke Evacuator. It actively removes surgical smoke and replaces the abdominal

cavity with clean carbon dioxide, much like an insufflation device.



3.9.3 Minilap Instruments

Minilap instruments are defined as laparoscopic instruments that have a diameter of 3.5 mm or smaller.

They have been available for over a decade, but never really caught on because earlier iterations of the

product were poorly constructed. They suffered from minimal shaft strength and were therefore not suited

for usage in large surgeries. They were relegated for use in biopsies and only for very limited indications.

Currently, there is a strong trend towards these miniature products, which is further strengthened by the

decline of single port surgeries, a competitor to needlescopic surgery (surgeries that utilize minilap

instruments). Needlescopic surgery offers patients the added benefits of an improved cosmetic effect, and

an even less invasive option in comparison to standard laparoscopic surgery. Minilap instruments are also

easier for surgeons to use, as repositioning of the instruments is significantly easier.

3.9.4 3D Laparoscopic Systems

The rod lens laparoscope market in the U.S. has long been a mature market. Over the last few years,

growth was mainly due to replacement sales, as many end-users felt that the price premium commanded

by video lens laparoscopes did not warrant the marginal increase in clinical effectiveness. The

introduction of 3D laparoscope systems will effectively change the market for laparoscopes in the United

States. Early adapters to the video laparoscope systems or those that are looking for the best technology

available will be drawn to the 3D laparoscope, which offers significantly improved optics. 3D

laparoscopes can be used either as a stand-alone product, or in conjunction with robot-assisted



laparoscopy. The improved level of perception allows surgeons to not only diagnose, but perform long

surgeries while experiencing less fatigue. The response from experts who have used 3D laparoscopes is

overwhelmingly positive. Olympus released their 3D laparoscope in April 2013, and B. Braun Aesculap

released their EinsteinVision® system in 2012.



Documents

U.S. MARKET FOR LAPAROSCOPIC DEVICES · U.S. MARKET FOR LAPAROSCOPIC DEVICES iDATA_USLAP15_RPT Published in January 2015 By iData Research Inc., 2015 iData Research Inc. Suite 308