Introduction of Endoscopy
Endoscopy (also called a gastroscopy) is a medical procedure that allows a doctor to observe the inside of the body without performing major surgery. An endoscope (fibrescope) is a long flexible tube with a lens at one end and a video camera at the other. The end with the lens is inserted into the patient.
Light passes down the tube (via bundles of optical fibers) to illuminate the relevant area, and the video camera magnifies the area and projects it onto a television screen so the doctor can see what is there. Usually, an endoscope is inserted through one of the body’s natural openings, such as the mouth, urethra, or anus.
Specially designed endoscopes are used to perform simple surgical procedures, such as:
- Locating, sampling, or removing tumors from the lungs and digestive tract.
- Locating and removing foreign objects from the lungs and digestive tract.
- Taking small samples of tissue for diagnostic purposes (biopsy).
- Removing stones from the bile duct.
- Placing tubes (stents) through blockages in the bile duct, oesophagus, duodenum, or colon.
A range of endoscopes
Endoscopes have been developed for many parts of the body. Each has its own name, depending on the part of the body it is intended to investigate, such as:
- Bronchoscope – inserted down the trachea (windpipe) to examine the lung.
- Colonoscope – inserted through the anus to examine the colon (bowel).
- Gastroscope – inserted down the oesophagus to examine the stomach.
- Duodenoscope – inserted through the stomach into the duodenum to inspect and perform procedures on the bile duct and /or pancreatic duct, called ERCP (Endoscopic Retrograde Cholangio-Pancreatogram).
- Hysteroscope – inserted through the cervix to examine the uterus.
- Cystoscope and Ureteroscope – inserted via the urethra to inspect the urinary bladder and ureters.
Types of Endoscopy
Endoscopy is a procedure that allows a doctor to view the inside of a person’s body. Doctors use it to diagnose diseases in the following parts of the body:
- Urinary tract
Outline of Gastrointestinal Endoscopy System
Current gastrointestinal endoscopes for examining the esophagus, stomach, and large and small intestines are mostly videoscopes. Videoscopes have an electronic image sensor attached to the distal tip of the instrument. The videoscope system consists of the following equipment. The video system center converts the electrical signals from an image sensor
at the tip of a videoscope into video signals and displays them on an LCD monitor.
In addition to high-definition vision, the system supports various types of image processing including color enhancement and Narrow Band Imaging (NBI). The latest units are integrated with a light source and come equipped with an LED with a long life span. To improve color reproductivity, the system has adopted five-color LEDs supporting violet, blue, green, amber, and red. It also has an automatic dimming feature (automatically adjusts the brightness)
and a pump that transmits water and air.
1. Main body: LCD monitor, Video system center
The video system center converts the electrical signals from an image sensor at the tip of a videoscope into video signals and displays them on an LCD monitor. In addition to high-definition vision, the system supports various types of image processing including color enhancement and Narrow Band Imaging (NBI).
The latest units are integrated with a light source and come equipped with an LED with a long life span. To improve color reproductivity, the system has adopted five-color LEDs supporting violet, blue, green, amber, and red. It also has an automatic dimming feature (automatically adjusts the brightness) and a pump that transmits water and air.
The endoscope has three parts: the control section, the insertion section, and the connector section.
- Control Section
The angulation knob on the control section is connected to the tip of the endoscope by a series of wires. By turning the angulation knob, the bending section at the distal end bends horizontally and vertically allowing for easier insertion into the body and the ability to view 360 degrees within body cavities.
The endoscope also contains buttons (valves) for feeding air or water and for applying suction. Covering the opening in the air/water valve will feed air into the organ being observed and will gently expand it for a better view. Depressing this valve will feed water through the endoscope to wash the viewing lens.
Depressing the suction valve will allow the doctor to use the endoscope to suction any fluids which are obscuring a good view of the tissue. Endotherapy devices can be passed through the instrument channel
for performing endoscopic biopsy and other treatments.
- Insertion Section
On the tip of the insertion section, there are four main parts:
- Objective lens and image sensor
- Light guides that bring light from the light source through the endoscope
- Instrument channel outlet where endotherapy devices can be pushed in and out (also has a suction opening)
- Nozzle for feeding water and air.
The objective lens is typically a super-wide-angle lens in order to visualize a large area of tissue at one time. In order to view tumor tissue in a more detailed manner, some endoscopes have an optical zoom feature. They also support high-definition video displays. Light guide fiber bundles conduct light from the external light source through the endoscope to illuminate body cavities.
Endotherapy devices are pushed in and out of the instrument channel for harvesting tissue (biopsy), removing tumors, cauterizing bleeding lesions, etc. The nozzle on the distal tip is used to clean the lens with water and expand body cavities by insufflating them with air.
- Connector Section
The connector section connects the endoscope with the video system center through the universal cord. Supply of air and water is also performed through this connection.
- Imaging Management Hub
The imaging management hub simplifies the process of recording, managing, and editing high-resolution endoscopic images (video and still images).
Outline of Surgical Endoscopy System
The following instruments are used in endoscopic surgery. As open surgery is gradually being replaced by endoscopic surgery, the sophistication of endosurgical devices has increased.
Once the procedure is completed, medical professionals may opt to edit video recordings for documentation and analysis purposes.
1. Main body: LCD monitor, Video system center, Xenon light source for IR imaging
Surgical endoscopy systems include models that are compatible with 3D endoscopes, which make it easier to grasp depth, and models equipped with 4K monitors, which provide clear, high-definition images with greater detail.
The video system center with a built-in light source serves as a processor that converts the electrical signals from the videoscope into video signals to display on an LCD monitor and functions as a light source that supplies light to the scope tip via the light guide cable. Some xenon light source devices enable infra-red (IR) observation.
In general, videoscopes have a diameter of 5-10mm and a length of 300-370mm. Their tips contain a lens, a CCD image sensor, and light guide fiber bundles for bringing illumination into the body. Some models are straight, others have deflectable tips. The CCDs in Olympus endoscopes support high-definition imaging. Focusing is unnecessary due to their broad depth of field.
- Rigid Endoscope (Telescope)
A wide variety of telescopes are used for various types of diagnosis and treatment. Uses in urology include transurethral prostatectomy and nephrectomy (kidney removal). Uses in ear, nose, and throat include viewing, diagnosing, and treating the eardrum, nasal cavity, and vocal cords, which is performed using a thin rigid endoscope. Rigid endoscopes are also used for myomectomy in gynecology and for viewing, diagnosing, and treating inside joint cavities in orthopedics.
The insufflator feeds carbon dioxide gas into the abdominal cavity in order to expand it and create a working space to perform surgery. A special insufflation needle (Veress needle) delivers the carbon dioxide gas to the peritoneal cavity. The insufflator monitors the pressure of the peritoneal cavity and automatically pumps in additional gas needed to make up for gas that naturally leaks out during surgery.
- Imaging Management Hub
The imaging management hub simplifies the process of recording, managing, and editing high-resolution endoscopic images (video and still images).
Trocars are used to create an opening (portal) for passing endoscopic instrumentation into the body. The endoscope, forceps, electrosurgical knives, hemostatic/suturing equipment, etc., are then inserted through the trocar as needed for surgery. Olympus offers various types of trocars, such as ones that are available in diameters ranging from 5-15mm, ones that have an anti-slip balloon, and a threaded type. Currently, the most common trocars come with a sheath and are single-use.
There are various kinds of forceps—such as grasping forceps that hold tissue and needles, dissecting forceps that mechanically separate tissue, scissor forceps for cutting tissue, etc.
- Hemostasis Clip
In endoscopic surgery, clips are often used to quickly close a blood vessel and stop bleeding that cannot be controlled by other means. The clips are held in a pistol-shaped clip applier. Clips are applied repeatedly like a stapler.
- Ultrasonic Energy Device
Ultrasonic devices for coagulation and cutting by converting electricity into ultrasonic vibrations. The heat is generated when the tip of the device (scissors) contacts the tissue and then cuts the tissue and causes coagulation (hemostasis).
- High-Frequency Electrosurgical Device (Electrode)
Olympus has commercialized electrosurgical knives that use high-frequency currents as an energy source. These devices come in two types, monopolar with one electrode and bipolar with two electrodes. Bipolar knives in particular are capable of ablation for small lesions, for example. This minimizes the risk of thermal damage to surrounding tissue.
- Fully-Integrated Bipolar/Ultrasonic Energy Devices
Combining the excellent hemostatic capabilities (controlling bleeding) of bipolar high-frequency energy with precise dissection of ultrasonic energy, the energy device can perform multiple tasks of vessel sealing, hemostasis, coagulation, incision, and dissection in one unit. The device meets surgeon’s demands for superior medical effectiveness.
Endoscopies fall into categories, based on the area of the body that they investigate.
|Where scope is inserted
|Doctors who typically perform the surgery
|Top Company in which it is designed with a model name.
|Through a small incision near the examined joint
|Into the nose or mouth
|Pulmonologist or Thoracic Surgeon
|Through the anus
|Gastroenterologist or Proctologist
|Through the urethra
|Through the mouth or anus
|Inside of the uterus
|Through the vagina
|Gynecologists or Gynecological Surgeons
|Olympus America, HYF-V
|Abdominal or Pelvic area
|Through a small incision near the examined area
|Various types of surgeons
|Stryker, 1588 AIM
|Through the mouth or nostril
|Otolaryngologist, also known as an ear, nose, and throat (ENT) doctor
|Stryker, HD Laryngoscope 70 (WA96100A)
|Mediastinum, the area between the lungs
|Through an incision above the breastbone
|Olympus America, WA52050A
|Through your nose and sinuses
|Stryker, 1688 AIM 4K
|Rectum and the lower part of the large intestine, known as the sigmoid colon
|Into the anus
|Gastroenterologist or Proctologist
|Olympus EMEA, CF-XZ1200L/I
|Thoracoscopy, also known as a Pleuroscopy
|Area between the lungs and the chest wall
|Through a small incision in the chest
|Pulmonologist or Thoracic Surgeon
|Olympus Canada, LTF-160
|Upper Gastrointestinal endoscopy, also known as an Esophagogastroduodenoscopy
|Esophagus and upper intestinal tract
|Through the mouth
|Olympus EMEA, GIF-1100
|Through the urethra
The India Endoscopy Devices Market size is expected to grow from USD 1.29 billion in 2023 to USD 1.81 billion by 2028, at a CAGR of 6.90% during the forecast period (2023-2028). 1
Endoscopes are minimally invasive devices that can be inserted into natural openings of the body to observe an internal organ or a tissue in detail. The endoscopic surgeries are performed for imaging procedures and minor surgeries as well.
The increasing prevalence of endoscopy surgeries for treatment and diagnosis and technological advancements are leading to enhanced applications, augmenting the market’s growth. In October 2020, Olympus Corporation, in cooperation with the Ministry of Internal Affairs and Communications (MIC), conducted a study titled ” Survey Study for International Expansion of AI Diagnosis Support System Using Ultra-High Magnifying Endoscopes in India”.
The study aims to develop advanced endoscopy diagnostics in India, where there are relatively few endoscopists. In collaboration with Cybernet Systems Co. Ltd, Olympus established an AI diagnostic support system at a major medical institution, the Asian Institute of Gastroenterology (AIG), based in Hyderabad, India. Also, the growing awareness among the elderly population about minimally-invasive procedures and the rising prevalence of chronic diseases boost the demand for endoscopy devices further. 2
However, the lack of skilled technicians in the country is likely to hinder the market’s growth.
The Indian endoscopy devices market is fragmented and consists of several major players. A few of the major players are currently dominating the market in terms of share. The majority of the global players have their presence in India in the form of branches, partnerships, subsidiaries, or third-party distribution. As the Indian market is becoming more lucrative due to the increased population and augmented standard of living, more companies are expected to invest and operate in India.
The rising vulnerability of the geriatric individuals to chronic illnesses, such as orthopedic, gastrointestinal, ophthalmology, and cancer due to decreased immunity and deteriorating health will drive the market growth. To that end, a large number of medical device manufacturers are developing medically sophisticated technologies to meet the rising requirements for minimally invasive surgical treatments conducted in a safe and efficient manner. For instance, in May 2023, the Olympus Corporation gained FDA certification for the EVIS X1 endoscopic system, which includes two interchangeable gastrointestinal endoscopes.
Endoscopy Devices Market Segmentation by Application, Product, and Geography Analysis
- Application Analysis
The market share growth by the laparoscopy segment will be significant during the forecast period. There is an increased need for laparoscopy when conventional and non-invasive methods such as ultrasound, X-ray, CT scan, and MRI do not provide an accurate diagnosis or do not provide sufficient information for the diagnosis. In addition, laparoscopy has many applications, including cholecystectomy (removal of the gallbladder), in the diagnosis of gastric cancer, pelvic inflammatory disease, general surgery, hernia repair surgery, Gastric restriction, and Nissen fundoplication.
The laparoscopy segment was valued at USD 8,358.99 million in 2017. Laparoscopy is a procedure used to examine the organs inside the abdominal cavity. Continuous advancements in endoscopy help the market to grow further. For example, Olympus’s ENDOEYE II video endoscope offers HD /image quality and superior illumination and is available with chip-on-the-tip technology for bright, clear /images. These endoscopes also feature proprietary narrowband imaging technology, which improves visual visualization of the mucosal area. Thus, these factors will drive the growth of the laparoscopy segment in the global endoscopy devices market during the forecast period.
- Product Segment Analysis
Accessories and others
Some of the products in this segment are light sources, cameras, video cameras, processors, camera heads, video converters, transmitters, printers, digital capture systems, light cables, cleaning brushes, surgical instruments, needle holders, mouthpieces, and biopsy valves, as well as electronic and mechanical endoscopic equipment. Demand for this segment is growing with increasing demand for end-user endoscopes. Sellers of disposable and reusable products as well as innovative products focus on reducing healthcare costs and improving hygiene levels. As a result, such factors will drive the growth of accessories and other segments during the forecast period.
Endoscopes come in three types, namely gid, flexible, and capsule endoscopes. Rigid endoscopes are used when organ anatomy is straight and there are no bends or curvature. Flexible endoscopes include flexible fiber optic endoscopes and flexible video endoscopes. Capsule endoscopy also eliminates the risk of infection. Furthermore, increasing awareness programs have the potential to benefit the market. For example, the CDC raises awareness about colon cancer with the Colorectal Cancer Control Program (CRCCP) across the US. Under the program, men and women over the age of 50 are screened for colorectal cancer. Thus, such initiatives have the potential to increase the adoption of capsule endoscopy and thus promote the growth of the market.
- Regional Analysis
North America is estimated to contribute 41% to the growth of the global market during the forecast period. Technavio’s analysts have elaborately explained the regional trends and drivers that will shape the market during the forecast period. The increasing prevalence of chronic diseases such as arthritis, gastrointestinal diseases, and ENT disorders are contributing to the growth of the market. These chronic diseases require diagnostic medical procedures such as endoscopy to examine and provide /images of the inside of the body and organs, something that standard examinations cannot do, therefore contributing to the demand for endoscopic devices.
Furthermore, the market is driven by factors such as rising patient awareness of various diseases and the importance of preventive healthcare. As a result, increasing public awareness of the risk of colorectal cancer and the benefits of early treatment has significantly increased the adoption rate of laparoscopic procedures. Favorable return policies available for various endoscopic procedures are likely to benefit the market. Hence, such factors are expected to drive market growth in this region during the forecast period.
Key Endoscopy Devices Market Players
Companies are implementing various strategies, such as strategic alliances, partnerships, mergers and acquisitions, geographical expansion, and product/service launches, to enhance their presence in the market. Few market players like:
- Arthrex Inc.
- Boston Scientific Corp.
- Ecleris USA
Endoscopy Devices Market: Key Drivers, Trends, Challenges, and Recent Developments. There are multiple factors influencing market growth.
Key Endoscopy Devices Market Drivers
Growing demand for video endoscopy systems is driving the growth of the market. A video endoscope is a fiber optic endoscope with a camera attachment, which is used to view internal organs such as the stomach, esophagus, and others. These video endoscopes represent pioneering technology in the field of medical imaging for the diagnosis and treatment of various conditions. Due to the growing demand for video endoscopes, market players are focusing on the design and manufacture of advanced video endoscopes used in various diagnostic and therapeutic applications.
Moreover, global and emerging market players are trying to increase their market share by providing next-generation systems to end users. Market players such as KARL STORZ and PENTAX have brought to market very advanced video scopes. For example, the G-EYE HD+ video endoscope supplied by PENTAX Medical is intended for the optical visualization of the gastrointestinal tract as well as the diagnosis and treatment of related diseases. Therefore, due to technical advancements, improved design, accurate diagnosis, and reliable results, the demand for video endoscopy systems is increasing, thereby contributing to the growth of the market.
Significant Endoscopy Devices Market Trends
The growing popularity of capsule endoscopy is the primary trend in the market. Capsule endoscopy is a procedure that involves injecting a capsule, which records an /image of the digestive tract. The capsule is disposable and about the size of a pill, containing a light source, transmitter, and miniature video camera. As the capsule passes through the digestive tract, it has thousands of /images transmitted to the recorder. Capsule endoscopy is recommended as a third step of investigation if colonoscopy and gastroscopy are negative.
Furthermore, players are innovating capsule endoscopy by incorporating technological advancements. For example, the Olympus MAJ-2029 endoscopic recorder delivers optimal clinical performance, improves ease of use, and enables real-time process visualization. In addition, the company ENDOCAPSULE (MAJ-2027) offers high-resolution /images with a wide field of view, four white LEDs, and an ultra-compact lens. Hence, with the increase in gastrointestinal disorders, the launch of new endoscopic capsules is likely to contribute to their demand and usage, thereby driving the growth of the market during the forecast period.
Major Endoscopy Devices Market Challenges
The lack of skilled professionals is a challenge that affects the growth of the market. Endoscopic procedures require highly trained professionals to prevent a number of risks and complications for the patient. A lack of expertise in using an endoscope during an examination can lead to misdiagnosis and harm to the patient. Endoscopic procedures require a thorough understanding of the device as well as human anatomy so that the technician handling the device can navigate the human body and locate a target for surgery or diagnosis.
Furthermore, in hospitals and other healthcare settings, staff should be trained in the use of endoscopes and understand the additional reprocessing steps required to prevent possible cross-contamination. the patient’s potential for infection. Therefore, the shortage of skilled and specialized endoscopic technicians is likely to preclude the use of endoscopic devices and impede market growth during the forecast period.
For example, in June 2020, Johnson & Johnson delivered its first Ultra High Definition 4K endoscopic imaging system in China that is not only the first 4K endoscopic imaging system in China but also marks the first time that the firm has manufactured a product representing this technology in the industry.
For example, in October 2021, Fujifilm Company launched the first FDA-cleared dual-channel endoscope for lower and upper gastrointestinal applications.
India Endoscopy Devices Market News
- In May 2021, UnivLabs Technologies became India’s first company to indigenously design and manufacture a full-fledged 4K Endoscope Tower.
- In February 2020, Fujifilm India Private Limited expanded its footprint by launching a new office in India. The company plans to increase its workforce by 30% across functions like Electronic Imaging Division, Instax, Industrial Products, and Medical Systems.
Comparison of different cameras of endoscopes with different companies.
|1688 AIM 4K Camera System
|Synergy HD Camera
|₹ 35,00,000/ Piece
|₹ 7,00,000/ Piece
|₹ 4,75,000/ Piece
|₹ 2,10,000/ Piece
Some of the major players operating in the endoscope devices market are:
- Arthrex Inc.: Arthrex Inc. (Arthrex) designs and manufactures surgical products and solutions used for arthroscopic and minimally invasive orthopedic surgical procedures. Arthrex is headquartered in Naples, Florida, the US.
Product : AR-3070AW, Arthrex HD Endoscope, 70°, 4 x 177 mm
- Olympus: Olympus Corp (Olympus) is a company that produces precise machinery and instruments for optics and digital technology. The company develops, manufactures, and commercializes equipment and devices for medical, healthcare, imaging, information, and other industrial markets. Through its subsidiaries and facilities, the company operates in the Americas, Europe, and Asia-Pacific. Olympus Corp is headquartered in Tokyo, Japan.
Product: The New EVIS LUCERA BF-260 Series
Price: Rs. 8,15,540/-
- Boston Scientific Corp.: Boston Scientific Corp (Boston Scientific) is a medical technology company that develops, manufactures and commercializes devices for a range of interventional medical specialties. It sells products directly and also through a network of distributors and dealers in Europe, the Middle East, Africa, Asia Pacific and the Americas. Boston Scientific is headquartered in Marlborough, Massachusetts, the US.
Product: Acquire™ Endoscopic Ultrasound Fine Needle Biopsy (FNB) Device
Price: Rs. 3400/- per piece
- Stryker: Stryker Corp (Stryker) is a medical technology company which is engaged in manufacturing an array of orthopedic, medical and surgical, and neurotechnology and spine products and allied services. Its major products include orthopedic implants; surgical equipment and surgical navigation systems; patient handling, emergency medical equipment and intensive care disposable products; and endoscopic and communications systems. It also offers neurosurgical equipment, neurovascular and spinal devices; and medical devices for use in a variety of conditions. Stryker offers products to doctors, hospitals, and other healthcare facilities. The company sells its products through subsidiaries, branches, third-party dealers, and distributors in the Americas, Europe, Asia-Pacific, the Middle East, and Africa. Stryker is headquartered in Kalamazoo, Michigan, the US.
Product : Stryker’s 1688 AIM 4K camera
A) Connected OR Hub
- B) PneumoClear
- C) 1688 Camera Control Unit
- D) L11 LED Light Source
- E) 4K Surgical Display
- F) SPY-PHI
- G) Synk 4K
- H) VPI
- I) Printer
Price: Rs 3500000/piece
- Ecleris USA: Ecleris develops and manufactures medical and dental equipment. Ecleris is a medical and dental equipment manufacturer that makes CO2 insufflators, endodigi, automobiles, headlights, colposcopes, splitter, endo chambers and light sources, frax face, cavix, and other items. They serve microscopy, colposcopy, endoscopy, ENT, gynecology, surgery, and aesthetic medicines.
Product: PROCAM SD
Price : ₹ 2,50,000 / Piece