The Total Addressable Market (TAM) for gastrointestinal endoscopy was valued at USD 14,245 million in 2022. It is estimated to reach USD 25,752 million by 2031, growing at a CAGR of 6.24% during the forecast period (2023–2031). Endoscopes, known as gastrointestinal endoscopes, are used to examine the GI tract (upper and lower GI tract). Endoscopy has been used to explore and visualize the interiors of the human body since the early 1800s. In 1805, Bozzini, a German physician, used a ‘lichtleiter’ to examine the genitourinary (GU) tract. Later, in 1855, another physician named Desormeaux added a light source using a light lamp for better visualization. Endoscopes have developed significantly over time for better therapeutic and diagnostic uses.
In 1932, a semi-flexible gastroscope, the Wolf-Schindler gastroscope, was introduced, which tremendously enhanced the efficacy and safety of gastroscopy. This discovery led to the invention of various other semi-flexible endoscopes in the coming years, and the landscape of gastrointestinal endoscopy transformed substantially. The gastrointestinal (GI) endoscopy market witnessed a lot of new technological advancements, such as the invention of charge-coupled devices (CCD), the introduction of capsule endoscopy, and robot-assisted endoscopic surgeries. The most recent disruptive trend is the introduction of single-use endoscopes and AI-based endoscopy aid devices.
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Gastrointestinal endoscope equipment integrated with video cameras is used to visualize the upper GI tract from the pharynx to the duodenum and the lower GI tract from the anus to the cecum. Gastrointestinal endoscope devices aid the diagnosis and can be used as a therapeutic intervention. One of the major causes of digestive disease is obesity. Obesity increases the chances of acquiring gastrointestinal disorders and is linked to a lower therapeutic response, resulting in unfavorable clinical results.
According to a study by the International Agency for Research on Cancer (IARC) published in 2020, gastrointestinal cancer is responsible for 26% of cancer cases worldwide and 35% of cancer-associated mortality. Endoscopy is the standard diagnostic procedure for the early detection of GI cancers. Early detection by endoscopy may decrease the prevalence and deaths caused by gastrointestinal cancers. Due to the rise in GI cancer instances, obesity, and digestive disease cases, the global gastrointestinal endoscopy market is anticipated to grow.
The upper gastrointestinal endoscopy procedures are carried out using a flexible endoscope integrated with a light and video camera. During the process, an endoscope is inserted into the mouth and pushed through the esophagus, stomach, and duodenum to provide direct visualization for diagnostic or therapeutic purposes. Similarly, during lower gastrointestinal endoscopy procedures, an endoscope allows the visualization of the colon to detect colorectal polyps, rectal bleeding, or a change in bowel movement habits. It serves as a therapeutic intervention for other surgical procedures.
Gastrointestinal endoscopy surgery allows healthcare professionals to visualize the inside of a patient’s body without making any incision or through a small incision instead of operating through traditional open surgery. The adoption of minimally invasive procedures is rapidly increasing due to their various benefits. Minimally invasive surgery has decreased the incidence of infection, which has raised the likelihood of a speedy recovery and reduced the length of time patients need to spend in the hospital, both of which have contributed to the expansion of the market.
The lack of healthcare personnel is critical in the gastrointestinal endoscopy industry. Healthcare personnel is required not only for the operation of the endoscopes but also for reprocessing the endoscopes to ensure safety and efficacy for subsequent use. Another vital issue is the need for more training for the existing healthcare professionals in developing and underdeveloped countries. The issue can be divided into inadequate training opportunities and sufficient operating time. Although most healthcare professionals receive formal procedure training, they are likely to wait to perform it immediately after the training.
Surgeons require adequate time and practice to get accustomed to the procedure and serve it to patients. A substantial learning curve is necessary to adopt minimally invasive procedures. Sometimes, a loaner endoscope is also used when the endoscope is being reprocessed. Additional training is needed if that endoscope is different from the one utilized in the department, which will impede the market's expansion.
Artificial intelligence or computer-assisted diagnosis (CAD) enables medical devices to process the information captured by them and give a precise diagnosis. Computer-assisted diagnosis is a promising area in endoscopy. The application of artificial intelligence in gastric cancer includes the identification of the polyps, depth of invasion, and critical information for proper therapeutic decision-making. In April 2021, Medtronic plc received FDA approval for the first artificial intelligence-based GI Genius Intelligent Endoscopy Module. The AI-based endoscopy module can detect colorectal polyps during a routine colonoscopy, leading to early detection of colorectal cancers and aiding in favorable patient outcomes.
Followed by the success of robotic-assisted devices, a series of gastrointestinal endoscopy robotics technologies have been developed. The benefits of robotic-assisted endoscopes include maximum viewing surface area, ergonomic design for patient comfort, and caecal intubation. The Aero-O-Scope, a disposable colonoscope by GI View Ltd., navigates the colon through the subsequent inflation/deflation of two balloons. Recently, a soft worm robotic endoscope explicitly designed for minimizing patient discomfort has been evaluated. The technological advancements in gastrointestinal endoscopy devices create opportunities for the market’s growth.
The global gastrointestinal endoscopy market is segmented into type, end-user, and region.
By type, the global market is divided into gastrointestinal endoscopes and endoscopic systems and gastrointestinal endotherapy.
The gastrointestinal endotherapy segment owns the highest market share and is anticipated to grow at a CAGR of 5.41% over the forecast period. Gastrointestinal endotherapy has been further sub-segmented into ultrasound endoscopes, balloon dilators, gastrointestinal stents, biopsy devices, hemostasis devices, retrieval devices, ERCP devices, and others. These devices are used in combination with gastrointestinal endoscopes for therapeutic purposes. The therapeutic indications for ERCP are stone removal from pancreatic and biliary ducts, malignant and benign strictures, and pancreatic and bile leakage. ERCP can also diagnose cholangiocarcinoma, autoimmune cholangitis, solitary dilated duct, and primary sclerosing cholangitis.
Gastrointestinal stents play a crucial role in treating gastrointestinal strictures and leaks. The esophageal stents were initially used to alleviate dysphagia and obstruction caused by malignant tumors. However, they were made of rigid plastic and linked with high complications and morbidity. Currently, esophageal stents are made of metal alloy and used to treat malignant and benign esophageal indications. The pancreatic stents are similar to biliary stents, and they are shaped like J to stop the migration of the stents. The usage of pancreatic stents for reducing the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis has a high adoption rate. Balloon dilators are used for endoscopic stricture dilation and are available in various lengths and designs based on the need for the procedure. Balloon dilators are made in a way so that they can pass through an endoscope, and dilation can be observed. These can be used in pancreatic and bile ducts and during ERCP to enable visualization.
The gastrointestinal endoscopes and endoscopic systems segment can be sub-segmented into gastrointestinal videoscopes, capsule endoscopes, and visualization systems. The gastrointestinal videoscopes component has substantially changed the gastrointestinal endoscopy market's landscape. Earlier, rigid and fiberoptic endoscopes were available to diagnose and treat gastrointestinal indications. However, when gastrointestinal videoscopes, along with visualization systems such as light sources, cameras, monitors, and others, were introduced, the use of rigid and fiberoptic endoscopes subsided.
Furthermore, the capsule endoscope is gaining popularity for its easy usage and high diagnostic yields without making an incision. A capsule endoscope consists of a pill that, on ingestion, provides multiple pictures of the targeted organ for proper diagnosis. In 2021, Medtronic's PillCam Smart Bowel 3 secured FDA approval for at-home remote diagnosis. The key players that offer various gastrointestinal video scopes and visualization systems are Olympus Corporation, HOYA Corporation, and FUJIFILM Holdings Corporation.
By end-user, the global market is divided into hospitals, ambulatory surgery centers, and others.
The hospital segment is the highest contributor to the market and is expected to grow at a CAGR of 5.44% during the forecast period. Hospitals account for a significant share of the global gastrointestinal endoscopy market. The uptake of endoscopic procedures by private hospitals primarily drives the growth in the hospital segment. Due to the high cost of gastrointestinal endoscopy and its associated accessories and the steep learning curve for surgeons, these minimally invasive procedures are generally only available at the most affluent multispecialty private hospitals and clinics due to the financial constraints of public healthcare systems. However, this trend is changing due to the push toward reducing healthcare costs by shifting inpatient procedures to outpatient centers.
The high growth in ambulatory surgery centers can be attributed to the increased government focus on reducing healthcare costs with enhanced patient outcomes, significantly shifting patient care from inpatient to outpatient settings. Moreover, ambulatory surgery clinics offer outpatient surgeries at a lower price per episode and hence have the potential to enhance the worldwide efficiency of healthcare systems.
By region, the global gastrointestinal endoscopy market is divided into North America, Europe, Asia Pacific, Latin America, and the Middle East and Africa.
North America Dominates the Global Market
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North America is the highest contributor to the global gastrointestinal endoscopy market and is anticipated to grow at a CAGR of 5.48% during the forecast period. The North American region dominates the gastrointestinal endoscopy market due to better healthcare systems and infrastructure, the high adoption rate of new technology, increased demand for minimally invasive surgeries, high efficacy, and low relapse rate associated with endoscopic procedures. The U.S.-based significant players in the market are Medtronic plc, Boston Scientific Corporation, Cook Group Inc, and Teleflex Incorporated. On the other hand, the demand for gastrointestinal endoscopies in Canada is expected to grow a lot. However, the growth can be restricted by the need for more skilled healthcare professionals.
Europe is expected to grow at a CAGR of 6.40% over the forecast period. The European region is one of the innovation hubs in terms of technology. The primary reason is the presence of well-established regional players, such as Ambu A/S, KARL STORZ SE & Co. KG, and Richard Wolf GmbH. In addition, Germany holds a significant share of the market due to its better healthcare infrastructure and the presence of global and local market players. Additionally, Spain and Italy have the highest senior population, so the adoption rate of minimally invasive procedures is relatively high. The increased incidence of gastrointestinal cancer, along with the points mentioned above, requires increased gastrointestinal endoscopy tests, leading to the growth of the gastrointestinal endoscopy market. For instance, Ambu A/S, a well-established European player, pioneered disposable endoscopes. Currently, the company offers disposable duodenoscopes and gastroscopes and has a disposable colonoscope in the pipeline to be launched in 2022.
The Asia-Pacific region is the fastest-growing region for the global market due to the rising cases of gastrointestinal diseases, the shift from conventional surgeries to minimally invasive procedures, and the increasing geriatric population. The Asia-Pacific region consists of many emerging economies undergoing significant technological advancements and improvements in their healthcare systems. Several research studies are underway in China, Japan, Australia, and South Korea. The major players that offer a variety of endoscopes and endoscopy-related accessories are based in Asia-Pacific. The major players in the market based in Asia-Pacific are Olympus Corporation, HOYA Corporation, Fujifilm Holdings Corporation, and SonoScape Medical Corp. These companies have diverse product portfolios and a robust global presence. In addition, Japan holds a significant share in the Asia-Pacific gastrointestinal endoscopy market since it is a hub of well-established gastrointestinal companies such as Olympus Corporation, HOYA Corporation, and FUJIFILM Holdings Corporation.
The Latin American gastrointestinal endoscopy market is one of the emerging regional markets. The region comprises Brazil, Mexico, Chile, Cuba, Costa Rica, and the Dominican Republic. Although gastrointestinal disorders are high in Latin America, other significant factors, such as the shift to capsule endoscopy and disposable endoscope, are comparably lower in Latin America compared to other regions. However, the rising influx of medical tourism and the increasing demand for minimally invasive surgeries are a few factors that can boost the growth of the gastrointestinal endoscopy market. However, the poor reimbursement framework and the absence of skilled healthcare professionals are expected to hinder the development of the market.
The Middle East and African gastrointestinal endoscopy market are growing because there are many local players with different kinds of products. The players, such as GI View Ltd. and Limaca-Medical, have technologically advanced products. Another driver of the gastrointestinal endoscopy market in the Middle East and Africa is the growing burden of gastrointestinal diseases. Even though lack of money is one of the biggest problems for the gastrointestinal endoscopy market in the Middle East and Africa, lack of resources and skilled endoscopists are also likely to slow the market's growth.
The key players in the global gastrointestinal endoscopy market are