One of the major advances in surgery is the development of thermally based surgical systems and instrumentation, primarily those that utilize electrosurgery or radiofrequency (RF) as the energy form.  Thermal energy is now used in general surgery as a substitute for the knife or scalpel and to enact better hemostasis (control of blood flow).  This report describes traditional electrosurgical and thermal ablation products used to divide/cut destroy/ablate or modify tissue.

In 2005, the U.S. market for traditional electrosurgery products, including generators, instruments/accessories, and thermal ligature and specialized products, was estimated at approximately $1 billion.  This market is expected to grow at a compound annual rate of approximately 3.9%, reaching nearly $1.2 billion in 2010.  General and specialty procedures described in the traditional electrosurgery segment total approximately 17 million procedures annually and are forecast to grow to nearly 20 million in 2010.  This area includes open and laparoscopic/minimally invasive general surgery as well as specialty areas, including cardiovascular, cosmetic/reconstructive, neurosurgery, obstetrics and gynecology, arthroscopic/orthopedic and urologic surgery.

The more dynamic thermal necrotic/ablation products segment (defined as including various RF and non-RF based surgical products) was estimated at over $390 million in 2005.  This market is expected to grow at a healthy compound annual rate of approximately 11%, reaching more than $650 million in 2010.  Specialty procedures in this segment include aesthetics/skin remodeling/vein treatment, benign prostatic hyperplasia (BPH), cancer, gynecologic disorders, spinal disc denervation and urinary incontinence.

The total market for electrosurgical and thermal ablation surgical products is estimated at $1.4 billion in 2005 and is forecast to reach nearly $1.9 billion over the next five years.

This dynamic report from Medtech Insight includes analyses of products, technologies, current and forecast markets, competitors, and opportunities. Covered topics in this report include: electrosurgical generators, argon-based coagulators, electrosurgical pencils and tips, return electrodes, thermal ligation devices, minimally invasive instruments, Coblation devices, and percutaneous RF breast biopsy devices.  The thermal necrotic/ablation segment focuses on RF, laser and microwave-based BPH treatment, cancer ablation, endometrial ablation, skin tightening, vein treatment and urinary incontinence treatment, among other emerging technologies.

TABLE OF CONTENTS AND LIST OF EXHIBITS

EXECUTIVE SUMMARY

i.   Electrosurgery

a.  Electrosurgical Procedure Volumes, by Surgical Type

b.  Electrosurgical Market Analysis, by Surgical Type

c.  Electrosurgical Market Analysis, by Product Type

ii.   Thermal Ablation

a.  Thermal Ablation Procedure Volumes and Market Analysis

b.  Thermal Ablation Market Analysis, by Treatment Area

i.   Benign Prostatic Hyperplasia

ii.   Cancer

iii.  Menorrhagia

iv.  Skin Tightening

v.  Spinal Disc Denervation

vi.  Urinary Incontinence

iii.  Combined Electrosurgical and Thermal Ablation Products Market

iv.  Methodology

Exhibit ES-1:  Surgical Procedures Using Electrosurgical Products, Procedure Volumes Forecast, by Type, 2004-2010

Exhibit ES-2:  Electrosurgical Instruments and Accessories, Combined Market Forecast, by Surgical Type, 2004-2010

Exhibit ES-3:  Electrosurgical Generators, Instruments, and Accessories, Combined Market Forecast,  by Product Type, 2004-2010

Exhibit ES-4:  Minimally Invasive Thermal Ablation, Procedure Volumes Forecast, by Type, 2004-2010

Exhibit ES-5:  Minimally Invasive Thermal Ablation Products, Market Forecast, by Type, 2004-2010

Exhibit ES-6:  U.S. Electrosurgical and Thermal Ablation Products Market, 2005 and 2010

1. THERMAL ENERGY AND TECHNOLOGY OVERVIEW

1.1 Electrosurgery

1.1.1 Radiofrequency Overview

1.1.1.1 Frictional Heating and Impedence of Tissue

1.1.1.2 Monopolar and Bipolar Energy

1.1.1.2.1 Monopolar Devices

1.1.1.2.2 Bipolar Devices

1.1.1.3 Electrosurgical Cutting and Coagulation

1.1.1.3.1 Arc Cutting

1.1.1.3.2 Coagulation

1.1.1.3.3 Fulguration and Plasma Coagulation

1.1.1.4 Safety Considerations

1.1.1.4.1 Return Electrodes

1.1.1.4.2 Current Shunting

1.1.1.4.3 Effect of Current on Neural Reponses and Muscle Stimulation

1.1.1.4.4 Insulation Cracks

1.1.1.4.5 Capacitive Coupling

1.1.1.4.6 Risks of Electrosurgical Transurethral Resection of the Prostate

1.1.1.5 Electrocautery Heating Devices

1.1.1.6 Coblation

1.2 Thermal Ablation or Necrosis

1.2.1 Laser and other Light-Based Energy Sources

1.2.1.1 Laser Ablation

1.2.2 Microwave

1.2.3 High-Intensity Focused Ultrasound

1.3 Cryotherapy

Exhibit 1-1:    Electrical Impedance of Various Tissue Types

Exhibit 1-2:    Electrosurgical Cutting of Tissue via Arc Generation

Exhibit 1-3:    Electrosurgical Cutting of Tissue via Ionic Agitation

Exhibit 1-4:    Fulguration to Produce Wide Areas of Coagulation

Exhibit 1-5:    Plasma Spray to Produce Wide Areas of Coagulation

Exhibit 1-6:    ENCISION’s Active Electrode Monitoring Instrumentation

Exhibit 1-7:    ArthroCare’s Coblation Mechanism

Exhibit 1-8:    Microwave Interaction with Water Molecules

Exhibit 1-9:    High-Intensity Focused Ultrasound Therapy

Exhibit 1-10:  Cryoablation’s Mechanism of Action and Cell Necrosis

2. ELECTROSURGICAL PRODUCTS MARKET

2.1 Products

2.1.1 Electrosurgical Generators

2.1.1.1 ConMed

2.1.1.2 Valleylab/Tyco International

2.1.1.3 Other Competitors

2.1.1.3.1 Bovie/Aaron Medical

2.1.1.3.2 ELMED

2.1.1.3.3 ERBE USA/ERBE

2.1.2 Argon Beam and Neutral Plasma Coagulators

2.1.2.1 ConMed

2.1.2.2 ERBE USA/ERBE

2.1.2.3 Plasma Surgical

2.1.2.4 Valleylab/Tyco International

2.1.3 Thermal Ligature Devices

2.1.3.1 Ethicon Endo-Surgery/Johnson & Johnson

2.1.3.2 Gyrus Medical/Gyrus Group

2.1.3.3 OLYMPUS AMERICA/OLYMPUS

2.1.3.4 SurgRx

2.1.3.5 Starion Instruments

2.1.3.6 Valleylab/Tyco International

2.1.4 Electrosurgical Instruments and Accessories

2.1.4.1 Electrosurgical Pencils

2.1.4.1.1 ConMed

2.1.4.1.2 Valleylab/Tyco International

2.1.4.2 Electrode Pencil Tips and Electrodes

2.1.4.2.1 MEGADYNE Medical Products

2.1.4.2.2 Valleylab/Tyco International

2.1.4.3 Dispersive or Return Electrode Pads

2.1.4.3.1 ConMed

2.1.4.3.2 MEGADYNE Medical Products

2.1.4.3.3 Valleylab/Tyco International

2.1.5 Electrosurgical Products, by Surgical Specialty

2.1.5.1 Laparoscopic and Minimally Invasive Surgery

2.1.5.1.1 ConMed

2.1.5.1.2 Gyrus Medical/Gyrus Group

2.1.5.1.3 Intact Medical

2.1.5.1.4 Olympus America/Olympus

2.1.5.1.5 Rubicor Medical

2.1.5.1.6 Valleylab/Tyco International

2.1.5.2 Neurosurgery

2.1.5.2.1 Codman/Johnson & Johnson

2.1.5.2.2 Silverglide Surgical Technologies

2.1.5.2.3 Valleylab/Tyco International

2.1.5.3 Orthopedic Surgery

2.1.5.3.1 ArthroCare SportsMedicine/ArthroCare

2.1.5.3.2 Smith & Nephew Endoscopy/Smith & Nephew

2.1.5.4 Cardiovascular Surgery

2.1.5.5 Obstetrics and Gynecologic Surgery

2.1.5.5.1 CooperSurgical

2.1.5.5.2 Ethicon/Johnson & Johnson

2.1.5.5.3 Utah Medical Products

2.1.5.6 Urologic Surgery

2.1.5.6.1 Boston Scientific

2.1.5.6.2 Gyrus Medical/Gyrus Group

2.1.5.6.3 Olympus America/Olympus

2.1.5.7 Cosmetic and Reconstructive Surgery

2.1.5.7.1 Bovie/Aaron Medical

2.1.5.7.2 Clinicon

2.1.5.7.3 Valleylab/Tyco International

2.2 Procedure Volumes

2.2.1 General Surgery

2.2.2 Laparoscopic and Minimally Invasive Surgery

2.2.3 Neurosurgery

2.2.4 Orthopedic Surgery

2.2.4.1 Open Orthopedic Surgery

2.2.4.2 Arthroscopic Surgery

2.2.5 Cardiovascular Surgery

2.2.6 Obstetrics and Gynecologic Surgery

2.2.7 Urologic Surgery

2.2.8 Cosmetic and Reconstructive Surgery

2.2.9 Summary

2.3 Market Analysis

2.3.1 Electrosurgical Generators

2.3.2 Electrosurgical Instruments and Accessories

2.3.2.1 Open General Surgery

2.3.2.2 Laparoscopic and Minimally Invasive Surgery

2.3.2.3 Neurosurgery

2.3.2.4 Open Orthopedic Surgery

2.3.2.5 Arthroscopic Surgery

2.3.2.6 Cardiovascular Surgery

2.3.2.7 Open Obstetrics and Gynecologic Surgery

2.3.2.8 Laparoscopic and Minimally Invasive Obstetrics and Gynecologic Surgery

2.3.2.9 Urologic Surgery

2.3.2.10 Cosmetic and Reconstructive Surgery

2.3.3 Market Summary

2.3.3.1 Market Analysis, by Surgical Area

2.3.3.2 Market Analysis, by Product Area

2.4 Competitive Analysis

Exhibit 2-1:    2006, Selected Electrosurgical Generator Systems

Exhibit 2-2:    2006, Selected Argon Beam and Neutral Plasma Coagulators

Exhibit 2-3:    2006, Selected Thermal Ligature Products

Exhibit 2-4:    2006, Selected Electrosurgical Instruments and Accessories

Exhibit 2-5:    2006, Selected Electrosurgical Products Used in Laparoscopic and Minimally Invasive Surgery

Exhibit 2-6:    2006, Selected Electrosurgical Products Used in Neurosurgery

Exhibit 2-7:    2006, Selected Electrosurgical Products Used in Arthroscopic Surgery

Exhibit 2-8:    2006, Selected Electrosurgical Products Used in Minimally Invasive Gynecologic Surgery

Exhibit 2-9:    2006, Selected Electrosurgical Products Used in Urologic Surgery

Exhibit 2-10:  2006, Selected Electrosurgical Products Used in Cosmetic and Reconstructive Surgery

Exhibit 2-11:  Open General Surgery, Procedure Volumes Forecast, 2004-2010

Exhibit 2-12:  Laparoscopic and Minimally Invasive Surgery, Procedure Volumes Forecast, 2004-2010

Exhibit 2-13:  Neurosurgery, Procedure Volumes Forecast, 2004-2010

Exhibit 2-14:  Open Orthopedic Surgery, Procedure Volumes Forecast, 2004-2010

Exhibit 2-15:  Arthroscopic Surgery, Procedure Volumes Forecast, 2004-2010

Exhibit 2-16:  Open Cardiovascular Surgery, Procedure Volumes Forecast, 2004-2010

Exhibit 2-17:  Open Obstetrics and Gynecologic Surgery, Procedure Volumes Forecast, 2004-2010

Exhibit 2-18:  Laparoscopic and Minimally Invasive Obstetrics and Gynecologic Surgery,  Procedure Volumes Forecast, 2004-2010

Exhibit 2-19:  Urologic Surgery, Procedure Volumes Forecast, 2004-2010

Exhibit 2-20:  Cosmetic and Reconstructive Surgery, Procedure Volumes Forecast, 2004-2010

Exhibit 2-21:  Surgical Procedures Using Electrosurgical Products, Procedure Volumes Forecast,  by Type, 2004-2010

Exhibit 2-22:  Electrosurgical Generators, Market Forecast, 2004-2010

Exhibit 2-23:  Open General Surgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-24:  Laparoscopic and Minimally Invasive General Surgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-25:  Neurosurgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-26:  Open Orthopedic Surgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-27:  Arthroscopic Surgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-28:  Cardiovascular Surgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-29:  Open Obstetrics and Gynecologic Surgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-30:  Laparoscopic and Minimally Invasive Obstetrics and Gynecologic Surgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-31:  Urologic Surgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-32:  Cosmetic and Reconstructive Surgery, Electrosurgical Instruments and Accessories, Market Forecast, 2004-2010

Exhibit 2-33:  Electrosurgical Instruments and Accessories, Combined Market  Forecast, by Surgical Type, 2004-2010

Exhibit 2-34:  Electrosurgical Generators, Instruments, and Accessories, Combined Market Forecast, by Product Type, 2004-2010

Exhibit 2-35:  2005, Electrosurgical Products Market, Share by Supplier

3. THERMAL ABLATION PRODUCTS MARKET

3.1 Areas of Treatment

3.1.1 Benign Prostatic Hyperplasia

3.1.1.1 Medtronic

3.1.1.2 Boston Scientific

3.1.1.3 Ethicon/Johnson & Johnson

3.1.1.4 Urologix

3.1.2 Cancer

3.1.2.1 Liver Cancer

3.1.2.1.1 Boston Scientific

3.1.2.1.2 RITA Medical Systems

3.1.2.1.3 Valleylab/Tyco International

3.1.2.2 Other Cancers

3.1.2.2.1 Metastatic Bone Cancer

3.1.2.2.2 Bladder, Lung, and Renal Cancers

3.1.2.3 Non-Radiofrequency Cancer Ablation

3.1.2.3.1 Cryoablation

3.1.2.3.2 Microwave Ablation

3.1.2.3.3 High-Intensity Focused Ultrasound

3.1.3 Menorrhagia

3.1.3.1 Boston Scientific

3.1.3.2 Cytyc

3.1.3.3 Gynecare/Ethicon/Johnson & Johnson

3.1.4 Uterine Fibroids

3.1.4.1 InSightec

3.1.5 Skin Tightening

3.1.5.1 Alma Lasers

3.1.5.2 Candela

3.1.5.3 Cutera

3.1.5.4 Lumenis

3.1.5.5 Rhytec

3.1.5.6 Syneron Medical

3.1.5.7 Thermage

3.1.6 Spinal Disc Denervation

3.1.6.1 ArthroCare

3.1.6.2 Smith & Nephew

3.1.7 Female Stress Urinary Incontinence

3.1.7.1 Novasys Medical

3.1.7.2 SURx

3.1.8 Other Ablation Procedures

3.1.8.1 Gastroesophageal Reflux Disease

3.1.8.2 Fecal Incontinence

3.1.8.3 Varicose Veins

3.1.8.3.1 VNUS Medical Technologies

3.1.8.4 Cellulite Treatment/Body Sculpting

3.2 Market Analysis

3.2.1 Benign Prostatic Hyperplasia

3.2.2 Cancer

3.2.3 Menorrhagia

3.2.4 Skin Tightening

3.2.5 Spinal Disc Denervation

3.2.6 Urinary Incontinence

Exhibit 3-1:    Thermal Effects on Tissue

Exhibit 3-2:    2006, Selected Thermal Necrotic Treatments for Benign Prostatic Hyperplasia

Exhibit 3-3:    2006, Selected Cancer Radiofrequency Ablation Systems

Exhibit 3-4:    2006, Selected Endometrial Ablation Systems

Exhibit 3-5:    Endometrial Ablation Treatment and Procedure Times

Exhibit 3-6:    Minimally Invasive Thermal Ablation, Procedure Volumes Forecast, 2004-2010

Exhibit 3-7:    Minimally Invasive Thermal Ablation Products, Market Forecast, 2004-2010

Exhibit 3-8:    2005, Benign Prostatic Hyperplasia, Thermal Ablation Products Market, Share by Supplier

Exhibit 3-9:    2005, Cancer, Thermal Ablation Products Market, Share by Supplier

Exhibit 3-10:  2005, Menorrhagia, Thermal Ablation Products Market, Share by Supplier

4. COMPANY PROFILES

4.1   ArthroCare Corporation

4.2   Boston Scientific Corporation

4.3   ConMed Corporation

4.4   Cytyc Corporation

4.5   Gyrus Medical, Inc./Gyrus Group PLC

4.6   Intact Medical Corporation

4.7   Johnson & Johnson

4.8   Medtronic, Inc.

4.9   MEGADYNE Medical Products, Inc.

4.10 Novasys Medical, Inc.

4.11 RITA Medical Systems, Inc.

4.12 Syneron Medical LTD

4.13 Thermage, Inc.

4.14 Valleylab, Inc./Tyco International LTD

4.15 Urologix, Inc.

4.16 VNUS Medical Technologies, Inc.

APPENDIX:  COMPANY LISTING

Copyright 2006, Medtech Insight, LLC