Medical Robotics and Computer-Assisted Surgery: The Global Market (focus on Asia-Pacific and Emerging Markets)

• Publication date: October 2011

REPORT SCOPE INTRODUCTION STUDY BACKGROUND Information technology plays a key role in an ever-widening range of human activities, including surgery. Computers, working in tandem with a variety of microprocessor-enabled equipment and instruments, support and facilitate the work of the surgeon and have brought a level of safety and precision to surgery that would have been inconceivable just a few years ag...

REPORT SCOPE

INTRODUCTION

STUDY BACKGROUND

Information technology plays a key role in an ever-widening range of human activities, including surgery. Computers, working in tandem with a variety of microprocessor-enabled equipment and instruments, support and facilitate the work of the surgeon and have brought a level of safety and precision to surgery that would have been inconceivable just a few years ago.

These computers, electronic equipment, and instruments are referred to collectively as medical robotics and computer-assisted surgery (MRCAS) or, more dramatically, “the operating room of the future.” MRCAS is used in a growing number of operating rooms around the world, largely as a result of the growing popularity of minimally invasive surgical (MIS) techniques. Minimally invasive, or “keyhole” surgery is an alternative to traditional open-incision surgery in a growing number of procedures. MIS utilizes special instruments that can be inserted and manipulated through small incisions (sometimes no more than a few millimeters long) under remote optical or video guidance, greatly reducing patient trauma and recovery times.

The need to perform delicate surgical procedures safely in tight spaces where the surgeon cannot see directly has created a growing market for devices that act as extensions of the surgeon’s eyes and hands: remote imaging, data processing and feedback, and robotics. Meanwhile, MRCAS technology has been evolving, as have the medical and economic environments in which it is used. Populations are aging, increasing demand for a wide range of age-related surgical procedures such as heart and orthopedic surgery. Technological advances have expanded the range of surgical procedures that can be performed using minimally invasive techniques, making them accessible to even more people.

The structure of the hospital industry, the main user of MRCAS, is also changing as hospitals consolidate and other health care options such as walk-in surgical clinics become available to consumers. Private and government health insurers around the world are becoming more cost-conscious, forcing hospitals to re-evaluate their capital spending plans but strengthening the case for technologies that can reduce the cost of surgical procedures. Medical malpractice suits continue to be common in markets like the United States, so technologies that increase the precision and accuracy of surgery have obvious appeal.

In such a fast-moving field, there is a pressing need to develop and maintain an up-to-date base of market information in order to better understand the dynamics of the market for MRCAS devices and equipment.

GOALS AND OBJECTIVES

This report is an updated and expanded version of an earlier (2009) BCC Research analysis of U.S. and global markets for MRCAS equipment. The updated report is based on the most recent market information available, and analyzes technological, economic, and regulatory developments that may have a long-term impact on the size and structure of the MRCAS market. The new report also contains a more in-depth and detailed analysis of selected foreign markets than its predecessor.

More specific objectives of this report are to:

* Identify and segment the main types of MRCAS devices that have been commercialized to date.
* Analyze the historical and current volume and value of shipments of each of these product segments in specified applications and geographical markets.
* Identify and evaluate the impact of demographic, economic, and other factors that will drive future demand for MRCAS devices.
* Forecast the volume and value of product shipments by equipment type and application and by probabilities that future demand will be higher or lower than the baseline forecast.
* Identify promising new surgical procedures and products still in the development and testing stage and assess the probability that they will be commercialized successfully within the next 5 years,
* Forecast the potential market for these developmental procedures and products, taking into account the estimated probability that they will be commercialized.
* Identify leading manufacturers of the devices and analyze the structure of the MRCAS industry (e.g., market shares, concentration, and recent M&A activity).
* Assess the long-term outlook for MRCAS equipment, taking into account market opportunities as well as technological, financial, and economic factors.

INTENDED AUDIENCE

This report has been written for the entire MRCAS interest community, especially those in:

* The medical and surgical devices industry
* Medical research institutions
* Investors
* The financial and analyst community

Although the report is structured around specific technologies, it is largely non-technical in nature. That is, it is concerned less with theory and jargon than with what works, how much of the latter the market is likely to purchase, and at what price.

As such, the report’s main audience is executive management and marketing and financial analysts. It is not written specifically for scientists and technologists, (although findings which concern the markets for their work, including the availability of government and corporate research funding for different technologies and applications) should interest them as well.

SCOPE AND FORMAT

This report is an analytical business tool with the primary purpose of describing the MRCAS equipment industry and the global market for these devices. MRCAS equipment is defined as computer- or microprocessor-enabled devices and accessories that are physically situated in the operating room and directly assist the surgeon in planning and carrying out surgical procedures. Thus, the scope of the study does not include:

* Devices that provide images and other information but are not an integral part of the MRCAS system, such as preoperative imaging (e.g., CT, MRI) equipment, laboratory and other analytical devices.
* Computerized medical records systems.
* Electronic operating room equipment such as heart monitors that enable the surgical team to monitor the patient’s condition but do not assist the surgeon directly in carrying out the operation.
* Other nonelectronic operating room equipment.

The format of the study is organized around the following topics:

* Major types and applications of MRCAS
* Industry structure
* Market size and segmentation, including historical data on sales by application, product type, and geographical market
* Market drivers
* Detailed market projections through 2016
* Competition and market shares
* Observations and conclusions regarding the future of the MRCAS market

METHODOLOGY AND INFORMATION SOURCES

Both primary and secondary research methodologies were used in preparing this report. The findings and conclusions of this report are based on information gathered from manufacturers and users of MRCAS and other informed sources. Interview data was combined with information gathered through an extensive review of secondary sources such as trade publications, trade associations, company literature, and online databases to produce the baseline market estimates contained in this report.

The base year for analysis and projection is 2010. With 2010 as a baseline, market projections were developed for 2011 to 2016. The market projections are “consensus” projections, obtained by averaging market scenarios obtained from industry and other sources or developed independently by BCC. The analytical methodologies BCC used to generate the market estimates are described in detail in the section on detailed market projections.

All dollar projections presented in this report are in 2010 constant dollars.

Global Surgical Equipment Industry

CHAPTER ONE: INTRODUCTION 1
STUDY BACKGROUND 1
GOALS AND OBJECTIVES ... 2
INTENDED AUDIENCE 2
SCOPE AND FORMAT .. 3
METHODOLOGY AND INFORMATION SOURCES ... 4
ANALYST CREDENTIALS 4
RELATED BCC RESEARCH . 4
BCC ONLINE SERVICES .. 5
DISCLAIMER . 5
CHAPTER TWO: EXECUTIVE SUMMARY ... 6
SUMMARY TABLE GLOBAL SALES OF MRCAS EQUIPMENT,
THROUGH 2016 ($ MILLIONS) . 6
SUMMARY FIGURE TRENDS IN GLOBAL SALES OF MRCAS
EQUIPMENT, 2010-2016 ($ MILLIONS) .. 6
EXECUTIVE SUMMARY (CONTINUED) 7
CHAPTER THREE: OVERVIEW 8
GENERAL DESCRIPTION AND DEFINITION OF MRCAS .. 8
GENERAL DESCRIPTION AND DEFINITION …
(CONTINUED) 9
FIGURE 1 MEDICAL ROBOTIC AND COMPUTER-ASSISTED
SURGICAL SYSTEMS .. 10
HISTORY OF MEDICAL ROBOTICS AND COMPUTER-ASSISTED
SURGERY 10
SURGICAL IMAGING TECHNOLOGIES ... 10
Surgical Imaging Technologies (Continued) .. 11
IMAGE REGISTRATION TECHNIQUES 12
COMPUTER IMAGE PROCESSING 13
SURGICAL ROBOTS . 14
“THE INTELLIGENT OPERATING ROOM” ... 15
SURGICAL SIMULATION 15
TECHNOLOGIES AND PRODUCTS .. 16
STANDALONE SURGICAL PLANNERS AND SIMULATORS . 16
Technology ... 16
Modeling of Organs and Deformations 16
Modeling of Organs …(Continued) ... 17
Simulation of Actions and Force Feedback
Reactions .. 18
Emerging Technologies . 19
Web-Based Surgical Simulators ... 19
Virtual Reality Simulators 20
Recent Patents .. 21
Advantages of Surgical Planners and Simulators . 22
Products ... 23
TABLE 1 STANDALONE SURGICAL PLANNERS AND SIMULATORS 23
Fifth Dimension Technologies .. 24
Haptica .. 24
CAE Healthcare 24
Mentice Medical Simulation . 24
Merge Healthcare . 25
Simbionix ... 25
SimQuest ... 26
SimSurgery ... 26
Surgical Science 26
VirtaMed ... 27
VOXEL-MAN 27
VRmagic 28
SURGICAL NAVIGATION SYSTEMS . 28
Technologies . 28
Imaging Technologies ... 28
Multimodal Imaging .. 28
Fluoroscopic Imaging . 29
Video-Enhanced Imagery .. 30
Microscopic Imagery .. 31
Endoscopic Imagery ... 32
Dynamic (Interventional) Imaging ... 33
Compact MRI Scanners .. 33
Intraoperative CT ... 34
Intraoperative Ultrasound . 35
Tracking Technologies .. 35
Optical Tracking . 35
Electromagnetic Tracking . 35
Display Technologies 36
Multiplanar Displays . 36
Three-Dimensional Displays . 36
Stereoscopic Displays . 37
Virtual and Augmented Reality 37
Heads-Up Displays 37
Recent Patents .. 38
Recent Patents (Continued) .. 39
Recent Patents (Continued) .. 40
Advantages of Surgical Navigation Systems .. 41
Products ... 41
Image-Guided Surgical Navigation Systems ... 42
TABLE 2 IMAGE-GUIDED SURGICAL NAVIGATION SYSTEMS .. 42
Boulder Innovation Group 43
FlashPoint 5500 .. 43
BrainLAB AG . 43
VectorVision 43
Kolibri .. 44
Med Surgical Services 44
CBYON Suite (CBYON) . 44
Medtronic 45
StealthStation . 45
Praxim/Orthopaedic Synergy 45
Nano-Station ... 45
Siemens Healthcare ... 46
NaviLink.. 46
Smith & Nephew 46
Dash . 46
Stryker Corp. .. 46
Stryker Navigation System II ... 46
ENlite ... 46
NavSuite .. 46
Zimmer 47
ORTHOsoft .. 47
Interventional Navigation Systems . 47
TABLE 3 INTERVENTIONAL SURGICAL NAVIGATION SYSTEMS . 47
TABLE 4 COMPARISON OF NONFLUOROSCOPIC
INTERVENTIONAL IMAGING TECHNOLOGIES ... 48
B. Braun Aesculap . 49
OrthoPilot 49
Kinamed.. 49
NaviPro 49
SONOWAND .. 49
SonoWand Invite 49
Odin/Medtronic .. 50
Polestar 50
Smith & Nephew 51
PiGalileo .. 51
Surgical Navigation Accessories and Add-Ons 51
TABLE 5 SURGICAL NAVIGATION ACCESSORIES AND ADD-ONS 52
Ascension Technology 52
Viking Stems .. 52
3D-HD Personal Head Display and
Infomatix 52
4navitec ... 53
Pointers, Trackers, Adapters, and
Other Accessories .. 53
SURGICAL ROBOTS . 53
Technology ... 53
Robotically Assisted Micromanipulation . 54
Steady-Hand Systems ... 55
Robotic “Wrists” and Other Dexterity
Enhancements . 55
Preprogrammed Robots 56
Constraint Robots . 57
Voice Control . 58
Other Emerging Technologies . 58
New Robotic Arm Designs 58
Remote Surgery. 59
Natural-Orifice Surgery ... 60
Microbots ... 61
Recent Patents . 61
Recent Patents (Continued) .. 62
Recent Patents (Continued) .. 63
Advantages of Robotics 64
Products ... 65
TABLE 6 SURGICAL ROBOTICS 65
TABLE 6 (CONTINUED) 66
Acrobot ... 66
Sculptor ... 66
Biobot Surgical .. 66
Mona Lisa ... 66
Corindus 67
CorPath 200 67
Curexo Technology 67
ROBODOC.. 67
Freehand ... 67
FreeHand 67
Given Imaging ... 68
Given Imaging Diagnostic System ... 68
Hansen Medical 68
Sensei .. 68
Hitachi Medical Systems .. 68
Magnetic Resonance Image-Guided Surgical
Robotic System . 68
Intuitive Surgical Systems ... 69
Da Vinci .. 69
MAKO Surgical . 70
RIO .. 70
Mazor Surgical Technologies 71
Renaissance 71
MicroDexterity .. 71
MicroDex . 71
Prosurgics .. 71
EndoAssist .. 71
PathFinder .. 72
Robotic Systems and Technologies ... 72
Penelope CS 72
Schaerer Mayfield . 73
NeuroMate .. 73
SOFAR ... 73
ALF-X .. 73
Titan Medical 74
Amadeus . 74
DIGITAL OPERATING ROOMS AND EQUIPMENT . 74
Technologies . 75
Data Routing . 75
User Interface ... 76
Open System Architectures .. 76
Recent Patents .. 77
Advantages .. 78
Products ... 78
TABLE 7 INTELLIGENT OPERATING ROOM SOLUTIONS AND
COMPONENTS . 79
Stryker ... 79
iSuite Operating Room of the Future ... 79
SIDNE . 80
Karl Storz .. 80
OR 1 . 80
Smith & Nephew ... 81
Digital Operating Room. 81
Intuitive Surgical .. 81
HERMES 81
Steris Corp. ... 82
3085 SP Operating Table/Harmony Surgical
Lighting System ... 82
Skytron Surgical ... 82
Stellar Surgical Lighting Systems (Skytron
Surgical) 82
Berchtold ... 82
CHROMOPHARE Surgical Lighting Systems 82
Valleylab 82
Force FX Electrosurgical Generator . 82
PRINCIPAL SURGICAL APPLICATIONS OF MRCAS . 83
TABLE 8 PRINCIPAL SURGICAL APPLICATIONS OF MRCAS . 83
ORTHOPEDIC APPLICATIONS .. 83
Hip Replacement . 84
Knee Replacement ... 85
Trauma . 85
Pedicle Screw Fixation and Other Spinal Procedures ... 86
NEUROSURGICAL APPLICATIONS .. 87
Stereotactic Biopsy .. 87
Craniotomy .. 88
Shunt 88
Implants ... 89
Deep Brain Stimulation .. 89
EAR, NOSE, AND THROAT (ENT) APPLICATIONS . 90
Functional Endoscopic Sinus Surgery 90
CARDIAC APPLICATIONS .. 90
Coronary Bypass Surgery ... 90
Heart Valve Repair and Replacement 91
Percutaneous Coronary Intervention . 91
OTHER ENDOSCOPIC APPLICATIONS 92
CHAPTER FOUR: THE GLOBAL MARKET FOR MRCAS EQUIPMENT 93
GLOBAL MRCAS MARKET 93
FIGURE 2 TRENDS IN THE GLOBAL MRCAS MARKET, 2010-2016 ($
MILLIONS) 93
MARKET BY COUNTRY/REGION . 93
TABLE 9 MAJOR INTERNATIONAL MARKETS FOR MRCAS
DEVICES AND EQUIPMENT, THROUGH 2016 ($ MILLIONS) . 94
FIGURE 3 GLOBAL MRCAS MARKET SHARES BY
COUNTRY/REGION, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) ... 94
FIGURE 3 (CONTINUED) . 95
MARKET BY TYPE OF EQUIPMENT 95
TABLE 10 GLOBAL MRCAS MARKET BY TYPE OF EQUIPMENT,
THROUGH 2016 ($ MILLIONS) ... 96
FIGURE 4 GLOBAL MRCAS MARKET SHARES BY EQUIPMENT
SEGMENT, 2010 VERSUS 2016 (PERCENT OF TOTAL SALES) ... 96
FIGURE 4 (CONTINUED) . 97
MARKET BY TYPE OF APPLICATION . 97
TABLE 11 GLOBAL MRCAS MARKET BY TYPE OF APPLICATION,
THROUGH 2016 ($ MILLIONS) .. 98
FIGURE 5 GLOBAL MRCAS MARKET SHARES BY APPLICATION
SEGMENT, 2010 VERSUS 2016 (PERCENT OF TOTAL SALES) ... 98
FIGURE 5 (CONTINUED) . 99
INDUSTRY STRUCTURE AND COMPETITION .. 99
OVERALL MARKET LEADERS ... 99
FIGURE 6 U.S. OVERALL MRCAS MARKET LEADERS, 2010
(PERCENT OF TOTAL SALES) . 100
TABLE 12 MAJOR MRCAS VENDORS’ MARKET SHARES, 2010 100
SURGICAL PLANNERS AND SIMULATORS .. 101
FIGURE 7 GLOBAL SURGICAL PLANNER AND SIMULATOR
MARKET LEADERS, 2010 (PERCENT OF TOTAL SALES) .. 101
SURGICAL NAVIGATION SYSTEMS ... 102
FIGURE 8 GLOBAL SURGICAL NAVIGATION SYSTEM MARKET
LEADERS, 2010 (PERCENT OF TOTAL SALES . 102
SURGICAL ROBOTS ... 102
FIGURE 9 GLOBAL SURGICAL ROBOT MARKET SHARES, 2010
(PERCENT OF TOTAL SALES) . 103
INTELLIGENT OPERATING ROOM SOLUTIONS . 103
FIGURE 10 GLOBAL INTEGRATED OPERATING ROOM SOLUTIONS
MARKET LEADERS, 2010 (PERCENT OF TOTAL SALES) ... 104
CHAPTER FIVE: ASIA-PACIFIC AND REST-OF-WORLD MARKETS FOR
MRCAS EQUIPMENT . 105
ASIA-PACIFIC 105
MARKET ENVIRONMENT 105
Demographics 105
TABLE 13 ASIA-PACIFIC MARKET DEMOGRAPHIC INDICATORS,
2010 .. 105
Economics .. 106
TABLE 14 ASIA-PACIFIC MARKET ECONOMIC INDICATORS, 2010 . 106
Regulatory Environment ... 107
Japan ... 107
China ... 108
India 109
Australia .. 109
New Zealand ... 110
MARKET SIZE AND SEGMENTATION 110
Overall Market .. 110
FIGURE 11 ASIA-PACIFIC REGION SALES OF MRCAS EQUIPMENT,
2010-2016 ($ MILLIONS) 110
Market by Country 111
TABLE 15 ASIA-PACIFIC MRCAS MARKET BY COUNTRY, THROUGH
2016 ($ MILLIONS) . 111
FIGURE 12 ASIA-PACIFIC MRCAS MARKET SHARES BY COUNTRY,
2010 VERSUS 2016 (PERCENT OF TOTAL SALES) ... 112
Market by Equipment Segment 113
TABLE 16 ASIA-PACIFIC MRCAS MARKET BY TYPE OF
EQUIPMENT, THROUGH 2016 ($ MILLIONS) .. 113
FIGURE 13 ASIA-PACIFIC MRCAS MARKET SHARES BY
EQUIPMENT SEGMENT, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) . 114
Market by Application Segment ... 115
TABLE 17 ASIA-PACIFIC MRCAS MARKET BY TYPE OF
APPLICATION, THROUGH 2016 ($ MILLIONS) 115
FIGURE 14 ASIA-PACIFIC MRCAS MARKET SHARES BY
APPLICATION SEGMENT, 2010 VERSUS 2016 (PERCENT OF
TOTAL SALES) ... 116
CHAPTER SIX: MIDDLE EASTERN AND AFRICAN MARKET FOR
MRCAS EQUIPMENT . 117
MARKET ENVIRONMENT ... 117
DEMOGRAPHICS 117
TABLE 18 MIDDLE EASTERN AND AFRICAN MARKET
DEMOGRAPHIC INDICATORS, 2010 .. 117
ECONOMICS ... 117
TABLE 19 MIDDLE EASTERN AND AFRICAN MARKET ECONOMIC
INDICATORS, 2010 . 118
REGULATORY ENVIRONMENT ... 118
Saudi Arabia .. 118
Turkey 118
MARKET SIZE AND SEGMENTATION .. 119
OVERALL MARKET 119
FIGURE 15 MIDDLE EASTERN AND AFRICAN MARKET FOR MRCAS
EQUIPMENT, 2010 THROUGH 2016 ($ MILLIONS) .. 119
MARKET BY COUNTRY . 119
TABLE 20 MIDDLE EASTERN AND AFRICAN MRCAS MARKET BY
COUNTRY, THROUGH 2016 ($ MILLIONS) ... 120
FIGURE 16 MIDDLE EASTERN AND AFRICAN MRCAS MARKET,
COUNTRY SHARES, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) . 120
FIGURE 16 (CONTINUED) . 121
MARKET BY EQUIPMENT SEGMENT 121
TABLE 21 MIDDLE EASTERN AND AFRICAN MRCAS MARKET BY
TYPE OF EQUIPMENT, THROUGH 2016 ($ MILLIONS) .. 122
FIGURE 17 MIDDLE EASTERN AND AFRICAN MRCAS MARKET
EQUIPMENT SHARES, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) . 122
FIGURE 17 (CONTINUED) . 123
MARKET BY APPLICATION SEGMENT .. 123
TABLE 22 MIDDLE EASTERN AND AFRICAN MRCAS MARKET BY
TYPE OF APPLICATION, THROUGH 2016 ($ MILLIONS) ... 124
FIGURE 18 MIDDLE EASTERN AND AFRICAN MRCAS MARKET
APPLICATION SHARES, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) . 124
FIGURE 18 (CONTINUED) . 125
CHAPTER SEVEN: VENDOR PROFILES . 126
ANAMEDIC . 126
BERCHTOLD GMBH . 126
BOULDER INNOVATION GROUP ... 127
BRAINLAB AG ... 127
B. BRAUN AESCULAP .. 128
CAE HEALTHCARE .. 128
CONMED CORP. 129
CUREXO TECHNOLOGY CORP. . 129
FIFTH DIMENSION TECHNOLOGIES ... 130
4NAVITEC GMBH .. 130
GE HEALTHCARE . 131
GIVEN IMAGING, LTD. 131
HANSEN MEDICAL (ROBOTICS) 132
HAPTICA 132
HITACHI MEDICAL CORP. .. 133
IMMERSION CORP. .. 133
INTEGRA RADIONICS, INC. 134
INTUITIVE SURGICAL, INC. ... 134
TABLE 23 INTUITIVE SURGICAL, INC., FINANCIAL
PERFORMANCE, THROUGH 2010 ($ MILLIONS) 135
KINAMED, INC. . 135
MAKO SURGICAL CORP. . 136
MAZOR SURGICAL TECHNOLOGIES, LTD. . 136
MED-SURGICAL SERVICES INC. ... 136
MEDTRONIC, INC. 137
MENTICE MEDICAL SIMULATION AB . 137
MERGE HEALTHCARE 138
MICRODEXTERITY SYSTEMS, INC. .. 138
MUSCULOGRAPHICS, INC. . 139
ODIN MEDICAL TECHNOLOGIES . 139
PRAXIM MEDIVISION .. 140
PROSURGICS, LTD. .. 140
ROBOTIC SURGICAL TECH, INC. .. 141
SCHAERER MAYFIELD NEUROMATE AG 141
SIEMENS HEALTHCARE . 142
SIMBIONIX USA CORP. 142
SIMSURGERY 143
SMITH & NEPHEW PLC ... 143
SONOWAND ... 144
STERIS CORP. 144
KARL STORZ GMBH . 145
STRYKER CORP. ... 145
SURGICAL SCIENCE AB .. 146
TITAN MEDICAL INC. .. 146
VIKING SYSTEMS, INC. ... 146
ZIMMER, INC. 147 CHAPTER ONE: INTRODUCTION 1
STUDY BACKGROUND 1
GOALS AND OBJECTIVES ... 2
INTENDED AUDIENCE 2
SCOPE AND FORMAT .. 3
METHODOLOGY AND INFORMATION SOURCES ... 4
ANALYST CREDENTIALS 4
RELATED BCC RESEARCH . 4
BCC ONLINE SERVICES .. 5
DISCLAIMER . 5
CHAPTER TWO: EXECUTIVE SUMMARY ... 6
SUMMARY TABLE GLOBAL SALES OF MRCAS EQUIPMENT,
THROUGH 2016 ($ MILLIONS) . 6
SUMMARY FIGURE TRENDS IN GLOBAL SALES OF MRCAS
EQUIPMENT, 2010-2016 ($ MILLIONS) .. 6
EXECUTIVE SUMMARY (CONTINUED) 7
CHAPTER THREE: OVERVIEW 8
GENERAL DESCRIPTION AND DEFINITION OF MRCAS .. 8
GENERAL DESCRIPTION AND DEFINITION …
(CONTINUED) 9
FIGURE 1 MEDICAL ROBOTIC AND COMPUTER-ASSISTED
SURGICAL SYSTEMS .. 10
HISTORY OF MEDICAL ROBOTICS AND COMPUTER-ASSISTED
SURGERY 10
SURGICAL IMAGING TECHNOLOGIES ... 10
Surgical Imaging Technologies (Continued) .. 11
IMAGE REGISTRATION TECHNIQUES 12
COMPUTER IMAGE PROCESSING 13
SURGICAL ROBOTS . 14
“THE INTELLIGENT OPERATING ROOM” ... 15
SURGICAL SIMULATION 15
TECHNOLOGIES AND PRODUCTS .. 16
STANDALONE SURGICAL PLANNERS AND SIMULATORS . 16
Technology ... 16
Modeling of Organs and Deformations 16
Modeling of Organs …(Continued) ... 17
Simulation of Actions and Force Feedback
Reactions .. 18
Emerging Technologies . 19
Web-Based Surgical Simulators ... 19
Virtual Reality Simulators 20
Recent Patents .. 21
Advantages of Surgical Planners and Simulators . 22
Products ... 23
TABLE 1 STANDALONE SURGICAL PLANNERS AND SIMULATORS 23
Fifth Dimension Technologies .. 24
Haptica .. 24
CAE Healthcare 24
Mentice Medical Simulation . 24
Merge Healthcare . 25
Simbionix ... 25
SimQuest ... 26
SimSurgery ... 26
Surgical Science 26
VirtaMed ... 27
VOXEL-MAN 27
VRmagic 28
SURGICAL NAVIGATION SYSTEMS . 28
Technologies . 28
Imaging Technologies ... 28
Multimodal Imaging .. 28
Fluoroscopic Imaging . 29
Video-Enhanced Imagery .. 30
Microscopic Imagery .. 31
Endoscopic Imagery ... 32
Dynamic (Interventional) Imaging ... 33
Compact MRI Scanners .. 33
Intraoperative CT ... 34
Intraoperative Ultrasound . 35
Tracking Technologies .. 35
Optical Tracking . 35
Electromagnetic Tracking . 35
Display Technologies 36
Multiplanar Displays . 36
Three-Dimensional Displays . 36
Stereoscopic Displays . 37
Virtual and Augmented Reality 37
Heads-Up Displays 37
Recent Patents .. 38
Recent Patents (Continued) .. 39
Recent Patents (Continued) .. 40
Advantages of Surgical Navigation Systems .. 41
Products ... 41
Image-Guided Surgical Navigation Systems ... 42
TABLE 2 IMAGE-GUIDED SURGICAL NAVIGATION SYSTEMS .. 42
Boulder Innovation Group 43
FlashPoint 5500 .. 43
BrainLAB AG . 43
VectorVision 43
Kolibri .. 44
Med Surgical Services 44
CBYON Suite (CBYON) . 44
Medtronic 45
StealthStation . 45
Praxim/Orthopaedic Synergy 45
Nano-Station ... 45
Siemens Healthcare ... 46
NaviLink.. 46
Smith & Nephew 46
Dash . 46
Stryker Corp. .. 46
Stryker Navigation System II ... 46
ENlite ... 46
NavSuite .. 46
Zimmer 47
ORTHOsoft .. 47
Interventional Navigation Systems . 47
TABLE 3 INTERVENTIONAL SURGICAL NAVIGATION SYSTEMS . 47
TABLE 4 COMPARISON OF NONFLUOROSCOPIC
INTERVENTIONAL IMAGING TECHNOLOGIES ... 48
B. Braun Aesculap . 49
OrthoPilot 49
Kinamed.. 49
NaviPro 49
SONOWAND .. 49
SonoWand Invite 49
Odin/Medtronic .. 50
Polestar 50
Smith & Nephew 51
PiGalileo .. 51
Surgical Navigation Accessories and Add-Ons 51
TABLE 5 SURGICAL NAVIGATION ACCESSORIES AND ADD-ONS 52
Ascension Technology 52
Viking Stems .. 52
3D-HD Personal Head Display and
Infomatix 52
4navitec ... 53
Pointers, Trackers, Adapters, and
Other Accessories .. 53
SURGICAL ROBOTS . 53
Technology ... 53
Robotically Assisted Micromanipulation . 54
Steady-Hand Systems ... 55
Robotic “Wrists” and Other Dexterity
Enhancements . 55
Preprogrammed Robots 56
Constraint Robots . 57
Voice Control . 58
Other Emerging Technologies . 58
New Robotic Arm Designs 58
Remote Surgery. 59
Natural-Orifice Surgery ... 60
Microbots ... 61
Recent Patents . 61
Recent Patents (Continued) .. 62
Recent Patents (Continued) .. 63
Advantages of Robotics 64
Products ... 65
TABLE 6 SURGICAL ROBOTICS 65
TABLE 6 (CONTINUED) 66
Acrobot ... 66
Sculptor ... 66
Biobot Surgical .. 66
Mona Lisa ... 66
Corindus 67
CorPath 200 67
Curexo Technology 67
ROBODOC.. 67
Freehand ... 67
FreeHand 67
Given Imaging ... 68
Given Imaging Diagnostic System ... 68
Hansen Medical 68
Sensei .. 68
Hitachi Medical Systems .. 68
Magnetic Resonance Image-Guided Surgical
Robotic System . 68
Intuitive Surgical Systems ... 69
Da Vinci .. 69
MAKO Surgical . 70
RIO .. 70
Mazor Surgical Technologies 71
Renaissance 71
MicroDexterity .. 71
MicroDex . 71
Prosurgics .. 71
EndoAssist .. 71
PathFinder .. 72
Robotic Systems and Technologies ... 72
Penelope CS 72
Schaerer Mayfield . 73
NeuroMate .. 73
SOFAR ... 73
ALF-X .. 73
Titan Medical 74
Amadeus . 74
DIGITAL OPERATING ROOMS AND EQUIPMENT . 74
Technologies . 75
Data Routing . 75
User Interface ... 76
Open System Architectures .. 76
Recent Patents .. 77
Advantages .. 78
Products ... 78
TABLE 7 INTELLIGENT OPERATING ROOM SOLUTIONS AND
COMPONENTS . 79
Stryker ... 79
iSuite Operating Room of the Future ... 79
SIDNE . 80
Karl Storz .. 80
OR 1 . 80
Smith & Nephew ... 81
Digital Operating Room. 81
Intuitive Surgical .. 81
HERMES 81
Steris Corp. ... 82
3085 SP Operating Table/Harmony Surgical
Lighting System ... 82
Skytron Surgical ... 82
Stellar Surgical Lighting Systems (Skytron
Surgical) 82
Berchtold ... 82
CHROMOPHARE Surgical Lighting Systems 82
Valleylab 82
Force FX Electrosurgical Generator . 82
PRINCIPAL SURGICAL APPLICATIONS OF MRCAS . 83
TABLE 8 PRINCIPAL SURGICAL APPLICATIONS OF MRCAS . 83
ORTHOPEDIC APPLICATIONS .. 83
Hip Replacement . 84
Knee Replacement ... 85
Trauma . 85
Pedicle Screw Fixation and Other Spinal Procedures ... 86
NEUROSURGICAL APPLICATIONS .. 87
Stereotactic Biopsy .. 87
Craniotomy .. 88
Shunt 88
Implants ... 89
Deep Brain Stimulation .. 89
EAR, NOSE, AND THROAT (ENT) APPLICATIONS . 90
Functional Endoscopic Sinus Surgery 90
CARDIAC APPLICATIONS .. 90
Coronary Bypass Surgery ... 90
Heart Valve Repair and Replacement 91
Percutaneous Coronary Intervention . 91
OTHER ENDOSCOPIC APPLICATIONS 92
CHAPTER FOUR: THE GLOBAL MARKET FOR MRCAS EQUIPMENT 93
GLOBAL MRCAS MARKET 93
FIGURE 2 TRENDS IN THE GLOBAL MRCAS MARKET, 2010-2016 ($
MILLIONS) 93
MARKET BY COUNTRY/REGION . 93
TABLE 9 MAJOR INTERNATIONAL MARKETS FOR MRCAS
DEVICES AND EQUIPMENT, THROUGH 2016 ($ MILLIONS) . 94
FIGURE 3 GLOBAL MRCAS MARKET SHARES BY
COUNTRY/REGION, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) ... 94
FIGURE 3 (CONTINUED) . 95
MARKET BY TYPE OF EQUIPMENT 95
TABLE 10 GLOBAL MRCAS MARKET BY TYPE OF EQUIPMENT,
THROUGH 2016 ($ MILLIONS) ... 96
FIGURE 4 GLOBAL MRCAS MARKET SHARES BY EQUIPMENT
SEGMENT, 2010 VERSUS 2016 (PERCENT OF TOTAL SALES) ... 96
FIGURE 4 (CONTINUED) . 97
MARKET BY TYPE OF APPLICATION . 97
TABLE 11 GLOBAL MRCAS MARKET BY TYPE OF APPLICATION,
THROUGH 2016 ($ MILLIONS) .. 98
FIGURE 5 GLOBAL MRCAS MARKET SHARES BY APPLICATION
SEGMENT, 2010 VERSUS 2016 (PERCENT OF TOTAL SALES) ... 98
FIGURE 5 (CONTINUED) . 99
INDUSTRY STRUCTURE AND COMPETITION .. 99
OVERALL MARKET LEADERS ... 99
FIGURE 6 U.S. OVERALL MRCAS MARKET LEADERS, 2010
(PERCENT OF TOTAL SALES) . 100
TABLE 12 MAJOR MRCAS VENDORS’ MARKET SHARES, 2010 100
SURGICAL PLANNERS AND SIMULATORS .. 101
FIGURE 7 GLOBAL SURGICAL PLANNER AND SIMULATOR
MARKET LEADERS, 2010 (PERCENT OF TOTAL SALES) .. 101
SURGICAL NAVIGATION SYSTEMS ... 102
FIGURE 8 GLOBAL SURGICAL NAVIGATION SYSTEM MARKET
LEADERS, 2010 (PERCENT OF TOTAL SALES . 102
SURGICAL ROBOTS ... 102
FIGURE 9 GLOBAL SURGICAL ROBOT MARKET SHARES, 2010
(PERCENT OF TOTAL SALES) . 103
INTELLIGENT OPERATING ROOM SOLUTIONS . 103
FIGURE 10 GLOBAL INTEGRATED OPERATING ROOM SOLUTIONS
MARKET LEADERS, 2010 (PERCENT OF TOTAL SALES) ... 104
CHAPTER FIVE: ASIA-PACIFIC AND REST-OF-WORLD MARKETS FOR
MRCAS EQUIPMENT . 105
ASIA-PACIFIC 105
MARKET ENVIRONMENT 105
Demographics 105
TABLE 13 ASIA-PACIFIC MARKET DEMOGRAPHIC INDICATORS,
2010 .. 105
Economics .. 106
TABLE 14 ASIA-PACIFIC MARKET ECONOMIC INDICATORS, 2010 . 106
Regulatory Environment ... 107
Japan ... 107
China ... 108
India 109
Australia .. 109
New Zealand ... 110
MARKET SIZE AND SEGMENTATION 110
Overall Market .. 110
FIGURE 11 ASIA-PACIFIC REGION SALES OF MRCAS EQUIPMENT,
2010-2016 ($ MILLIONS) 110
Market by Country 111
TABLE 15 ASIA-PACIFIC MRCAS MARKET BY COUNTRY, THROUGH
2016 ($ MILLIONS) . 111
FIGURE 12 ASIA-PACIFIC MRCAS MARKET SHARES BY COUNTRY,
2010 VERSUS 2016 (PERCENT OF TOTAL SALES) ... 112
Market by Equipment Segment 113
TABLE 16 ASIA-PACIFIC MRCAS MARKET BY TYPE OF
EQUIPMENT, THROUGH 2016 ($ MILLIONS) .. 113
FIGURE 13 ASIA-PACIFIC MRCAS MARKET SHARES BY
EQUIPMENT SEGMENT, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) . 114
Market by Application Segment ... 115
TABLE 17 ASIA-PACIFIC MRCAS MARKET BY TYPE OF
APPLICATION, THROUGH 2016 ($ MILLIONS) 115
FIGURE 14 ASIA-PACIFIC MRCAS MARKET SHARES BY
APPLICATION SEGMENT, 2010 VERSUS 2016 (PERCENT OF
TOTAL SALES) ... 116
CHAPTER SIX: MIDDLE EASTERN AND AFRICAN MARKET FOR
MRCAS EQUIPMENT . 117
MARKET ENVIRONMENT ... 117
DEMOGRAPHICS 117
TABLE 18 MIDDLE EASTERN AND AFRICAN MARKET
DEMOGRAPHIC INDICATORS, 2010 .. 117
ECONOMICS ... 117
TABLE 19 MIDDLE EASTERN AND AFRICAN MARKET ECONOMIC
INDICATORS, 2010 . 118
REGULATORY ENVIRONMENT ... 118
Saudi Arabia .. 118
Turkey 118
MARKET SIZE AND SEGMENTATION .. 119
OVERALL MARKET 119
FIGURE 15 MIDDLE EASTERN AND AFRICAN MARKET FOR MRCAS
EQUIPMENT, 2010 THROUGH 2016 ($ MILLIONS) .. 119
MARKET BY COUNTRY . 119
TABLE 20 MIDDLE EASTERN AND AFRICAN MRCAS MARKET BY
COUNTRY, THROUGH 2016 ($ MILLIONS) ... 120
FIGURE 16 MIDDLE EASTERN AND AFRICAN MRCAS MARKET,
COUNTRY SHARES, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) . 120
FIGURE 16 (CONTINUED) . 121
MARKET BY EQUIPMENT SEGMENT 121
TABLE 21 MIDDLE EASTERN AND AFRICAN MRCAS MARKET BY
TYPE OF EQUIPMENT, THROUGH 2016 ($ MILLIONS) .. 122
FIGURE 17 MIDDLE EASTERN AND AFRICAN MRCAS MARKET
EQUIPMENT SHARES, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) . 122
FIGURE 17 (CONTINUED) . 123
MARKET BY APPLICATION SEGMENT .. 123
TABLE 22 MIDDLE EASTERN AND AFRICAN MRCAS MARKET BY
TYPE OF APPLICATION, THROUGH 2016 ($ MILLIONS) ... 124
FIGURE 18 MIDDLE EASTERN AND AFRICAN MRCAS MARKET
APPLICATION SHARES, 2010 VERSUS 2016 (PERCENT OF TOTAL
SALES) . 124
FIGURE 18 (CONTINUED) . 125
CHAPTER SEVEN: VENDOR PROFILES . 126
ANAMEDIC . 126
BERCHTOLD GMBH . 126
BOULDER INNOVATION GROUP ... 127
BRAINLAB AG ... 127
B. BRAUN AESCULAP .. 128
CAE HEALTHCARE .. 128
CONMED CORP. 129
CUREXO TECHNOLOGY CORP. . 129
FIFTH DIMENSION TECHNOLOGIES ... 130
4NAVITEC GMBH .. 130
GE HEALTHCARE . 131
GIVEN IMAGING, LTD. 131
HANSEN MEDICAL (ROBOTICS) 132
HAPTICA 132
HITACHI MEDICAL CORP. .. 133
IMMERSION CORP. .. 133
INTEGRA RADIONICS, INC. 134
INTUITIVE SURGICAL, INC. ... 134
TABLE 23 INTUITIVE SURGICAL, INC., FINANCIAL
PERFORMANCE, THROUGH 2010 ($ MILLIONS) 135
KINAMED, INC. . 135
MAKO SURGICAL CORP. . 136
MAZOR SURGICAL TECHNOLOGIES, LTD. . 136
MED-SURGICAL SERVICES INC. ... 136
MEDTRONIC, INC. 137
MENTICE MEDICAL SIMULATION AB . 137
MERGE HEALTHCARE 138
MICRODEXTERITY SYSTEMS, INC. .. 138
MUSCULOGRAPHICS, INC. . 139
ODIN MEDICAL TECHNOLOGIES . 139
PRAXIM MEDIVISION .. 140
PROSURGICS, LTD. .. 140
ROBOTIC SURGICAL TECH, INC. .. 141
SCHAERER MAYFIELD NEUROMATE AG 141
SIEMENS HEALTHCARE . 142
SIMBIONIX USA CORP. 142
SIMSURGERY 143
SMITH & NEPHEW PLC ... 143
SONOWAND ... 144
STERIS CORP. 144
KARL STORZ GMBH . 145
STRYKER CORP. ... 145
SURGICAL SCIENCE AB .. 146
TITAN MEDICAL INC. .. 146
VIKING SYSTEMS, INC. ... 146
ZIMMER, INC. 147