Endoscopic Submucosal Dissection Market

Endoscopic Submucosal Dissection Market Size, Global Industry Forecast

The global endoscopic submucosal dissection market in terms of revenue was estimated to be worth $347 million in 2022 and is poised to reach $483 million by 2027, growing at a CAGR of 6.9% from 2022 to 2027. The rising incidence of target diseases such as cancer is expected to accelerate the need for endoscopic procedures, which, in turn, would propel the growth of this market in the coming years. Owing to the high capital, training, and maintenance costs, endoscopic submucosal dissection procedures are generally expensive. Also, in most Asian countries, there is limited or no reimbursement for ESD procedures from governments are factor expected to restrain the market growth to a certain extent in the coming years.

To know about the assumptions considered for the study, Request for Free Sample Report

Endoscopic Submucosal Dissection Market Dynamics

Drivers: Growing geriatric population

endoscopic submucosal dissection has become a useful minimally invasive treatment for elderly patients with early-stage gastric cancer, as it is less invasive than open surgical procedures and highly advantageous in organ preservation. ESD enables en-bloc resection even of extensive lesions and accurate pathological evaluation. Furthermore, the aging of the population is associated with an increased number of cases in which the selection of minimally invasive surgery is recommended for elderly patients from various perspectives, including post-operative quality of life (QOL) and procedural accidents. Compared to open surgical procedures, ESD is minimally invasive and has thus been established at various institutions as a highly effective endoscopic treatment for elderly patients.

Restraints: High overhead cost of ESD procedures with limited reimbursements

Endoscopic submucosal dissection has become an established procedure for the resection of pre-malignant lesions. Despite its benefits and cost-effectiveness, there are significant challenges in bringing ESD to mainstream practice, given the unpredictability of reimbursement. ESD is an efficient and cost-effective option for GI cancer patients. However, there are a few complications associated with the use of these devices, which result in additional healthcare costs. The average payment per procedure is USD 886.43 for esophageal ESD, USD 732.71 for gastric or duodenal ESD, and USD 1,325.35 for colon and/or rectal ESD. ESD is consistently under-reimbursed across insurance types when compared to surgical alternatives and endoscopist time. Despite the benefits associated with ESD, the adoption of the technique in the US is hampered by the lengthy learning curve and the lack of dedicated CPT codes after mastering the procedure.

Opportunities: Expected increase in adoption of and preference for endoscopic submucosal dissection procedures in developing countries

Endoscopic submucosal dissection was developed in Japan as a novel technique that allowed en bloc removal of early gastric neoplasia regardless of size. Subsequently, its indications expanded to superficial neoplasia in the esophagus and colon. ESD allows for the en bloc removal of neoplasia when en bloc EMR is not possible due to the size or invasion depth of the lesion. Currently, Japanese, American, and European societies provide guidelines for the indications of ESD. ESD is well-established as a modality for selected advanced lesions of both the upper and lower gastrointestinal tract but has not attained the same niche in developing countries due to a variety of reasons. These include competition from traditional surgery, minimally invasive surgery, and EMR. Other obstacles to ESD introduction include time commitment for learning and performing procedures, a steep learning curve, requirement of special equipment, lack of mentors, cost issues, interdisciplinary conflicts, concerns regarding complications, and lack of support from institutions and interfacing departments. One of the largest barriers to the adoption of ESD is that the operative time of ESD will remain longer than most endoscopic procedures (given the inherent nature of ESD). However, a decrease in procedural time is expected owing to technological advancements. This, in turn, is expected to increase the adoption and preference for endoscopic submucosal dissection procedures in developing countries during the forecast period.

Challenges: Risk of post-operative infection

Endoscopic submucosal dissection is a relatively new procedure used for the treatment of early gastrointestinal cancers, regardless of lesion size and configuration. It has gradually acquired popularity because of its minimally invasive nature. As compared to conventional endoscopic resection, ESD is a more complex procedure and requires a higher level of technical skill. Therefore, it is associated with a higher complication rate. Post-operative fever is one of the common complications. During ESD, the injection needle catheter is passed through the contaminated endoscopic channel and may directly inoculate bacteria into the bloodstream during the submucosal injection. In addition, ESD can produce mucosal defects. Submucosal and muscularis propria being exposed to native bacterial flora in the gastrointestinal tract may lead to bacteremia and/or endotoxemia. Bacteremia could be caused by the bacterial translocation of endogenous microbial flora through the injured mucosa into the bloodstream during the endoscopy procedure. These infectious complications have been reported to be infrequent and transient in both EMR and ESD of the stomach and colon.

Based on product, the knives segment will grow at the highest CAGR during the forecast period

Based on product, the endoscopic submucosal dissection market is segmented into knives, tissue retractors, graspers/clips, injection agents, gastroscopes and colonoscopes, and other products. The knives segment will continue to dominate the market in 2027, growing at the highest CAGR during the forecast period. In ESD, lesions are circumscribed with a knife to free the lesion completely from the rest of the normal mucosa. There are a variety of knives available in the market, and the field has evolved rapidly over the past two decades with efforts to improve efficacy, safety, and cost-effectiveness.

Based on indication, the esophageal cancer segment will grow at the highest CAGR during the forecast period

Based on indication, the endoscopic submucosal dissection market is segmented into stomach cancer, colon cancer, and esophageal cancer. The esophageal cancer segment will grow at the highest CAGR during the forecast period. The incidence of superficial esophageal cancer (SEC) is increasing, particularly in Asian countries, including Japan, where screening for upper digestive tract cancers is common.

Based on end user, the hospitals segment will grow at the highest CAGR during the forecast period

In 2021, the hospitals segment will grow at the highest CAGR during the forecast period. Investments and incentives received by hospitals from government bodies are few key factors for the growth of this segment.

North America is expected to account for the largest share of the endoscopic submucosal dissection market in 2021

To know about the assumptions considered for the study, download the pdf brochure

North America is expected to account for the largest share of the endoscopic submucosal dissection market in 2021. Its dominance in the global market is mainly attributed to the high healthcare spending in the country, favorable reimbursement policies for endoscopic procedures, increased incidence of cancer, constant research on endoscopy techniques, and a high number of FDA approvals for endoscopy systems in the US.

The prominent players in the endoscopic submucosal dissection market are Olympus Corporation (Japan), Boston Scientific Corporation (US), FUJIFILM Holdings Corporation (Japan), Sumitomo Bakelite Co., Ltd. (Japan), Creo Medical (UK), Medtronic (Ireland), MTW Endoskopie Manufaktur (Germany), HOYA Corporation (Japan), Ovesco Endoscope AG (Germany), Zeon Medical Inc. (Japan), KARL STORZ SE & Co. KG (Germany), ConMed Corporation (US), Micro-tech Endoscopy (China), Cook Group (US), Steris PLC (Ireland), Leo Medical Co., Ltd. (China), Erbe Elektromedizin GmbH (Germany), Taewoong Medical (South Korea), DCC Healthcare (Ireland), Kossen Co., Ltd. (South Korea), Innova Medica SPA (Italy), Jiangsu Vedkang Medical Science and Technology Co., Ltd. (China), Hangzhou AGS MedTech Co., Ltd. (China), and Beijing ZKSK Technology Co., Ltd. (China).

Endoscopic Submucosal Dissection Market Report Scope

Endoscopic Submucosal Dissection Market Report Segmentation

By Product

• Gastroscopes And Colonoscopes
• Knives
• Injection Agents
• Tissue Retractors
• Graspers/Clips
• Other Products

By Indication

• Stomach Cancer
• Colon Cancer
• Esophageal Cancer

By End User

• Hospitals
• Specialty Clinics
• Ambulatory Surgical Centers
• Other End Users

By Region

• North America
  • US
  • Canada
• Europe
  • Germany
  • France
  • UK
  • Italy
  • Spain
  • Rest of Europe
• Asia Pacific
  • Japan
  • China
  • India
  • Rest of Asia Pacific
• Latin America
• Middle East and Africa

Endoscopic Submucosal Dissection Market

Recent Developments

• In March 2021, FUJIFILM Holdings Corporation (Japan) acquired Diagnostic Imaging-related Business (the Business), Hitachi, Ltd.. This acquisition helped in the expansion of the medical systems business of FUJIFILM Corporation.
• In January 2021, Olympus Corporation (Japan) acquired Quest Innovations B.V. (Netherlands). The acquisition enabled Olympus to strengthen its surgical endoscopy capabilities and incorporate Quest’s advanced FIS capabilities into its comprehensive medical imaging portfolio.
• In November 2020, Creo Medical Group PLC (UK) acquired Boucart Medical SRL (Belgium). Creo Medical Group completed the acquisition of Boucart Medical SRL, the largest independent supplier of gastrointestinal endoscopy consumables in Belgium and Luxembourg.

Frequently Asked Questions (FAQs):

To speak to our analyst for a discussion on the above findings, click Speak to Analyst