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U.S. Markets for General and Pelvic Endoscopic Surgery Products
Report #A568 - March 2010
350 Pages – 121 Exhibits - 15 Company Profiles


Endoscopic surgery is a minimally invasive, closed procedure (as opposed to invasive open surgery where the surgeon cuts open the body to reach diseased tissue or organs). In endoscopic and laparoscopic procedures the targeted surgical site is accessed via natural orifices of the body or through access ports created by the surgeon at selected positions. The surgeon must abandon a direct, open view of the surgical site for images acquired by an endoscope that combines lighting and optics. However, due to several advantages—including reduced trauma, reduced scarring, and shorter patient recovery and cost—the types of procedures performed endoscopically continue to rapidly expand, driving market growth. Today, endoscopic surgery includes a growing number of specialty procedures in fields such as gastroenterology; obstetrics and gynecology; orthopedics; otolaryngology; thoracic surgery; and urological surgery. General and pelvic endoscopic/laparoscopic surgeries such as gastric bypass, endometrial ablation, laparoscopically assisted vaginal hysterectomy (LAVH), appendectomy, and prostatectomy totaled more than 2.8 million in 2008.

General and pelvic endoscopic surgical procedures employ a broad array of endoscopic surgical products, including access needles, trocars, hand-assisted laparoscopic surgery devices, endoscopes, hand instruments, insufflation systems and robotic-surgery systems. The U.S. market for products used in general and pelvic endoscopic surgery totaled more than $3.3 billion in 2008. Over the next five years, this burgeoning market is expected to grow at a healthy 9.0% compound annual rate, approaching $5.2 billion in 2013. Despite the current economic recession, strong pricing pressure and competition, this market is expected to exhibit healthier-than-average growth due to demographics, ongoing demand for less invasive, less-costly surgery, increased surgeon training, and adaption of next-generation endoscopic technologies, including robotic surgical systems and next-generation endoscopic instrumentation. In addition, emerging “scarless” techniques—including reducing the surgical access to a single incision or via natural orifices such as the umbilicus—have resulted in the development of several novel surgical instruments and systems that may significantly impact the field of laparoscopy.

This dynamic report from Medtech Insight includes analyses of products, markets, competitors, and emerging technology and opportunities in the U.S. general and pelvic endoscopic surgery products market. Product areas include: access needles, trocars, hand-assisted laparoscopic surgery devices, single-port access or single-incision laparoscopy systems, incisionless access systems, insufflation systems, endoscopes, hand instruments, endoscopic access site closure products, robotic-assisted minimally invasive surgery systems, and surgical navigation systems.

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U.S. Markets for General and Pelvic Endoscopic Surgery Products

A568

March 2010

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Methodology

Reports are produced exclusively by Medtech Insight, through extensive primary and secondary research among the clinicians, researchers, and competitors in the marketplace, and draw upon the industry expertise of a network of industry insiders. Medtech Insight exhaustively corroborates the data as a baseline for completing forward-looking analysis and providing insight into product, technology and market evolution.

 

TABLE OF CONTENTS

 

EXECUTIVE SUMMARY

i.    Endoscopic Surgery

a.   Specialty Endoscopic Procedures

ii.    Endoscopic Surgical Products

a.   Access Devices

b.   Access Site Closure Devices

c.   Endoscopes

d.   Hand Instruments

e.   Insufflation Devices

f.    Robotic-Assisted Minimally Invasive Surgical Systems

iii.   Emerging Technologies

iv.   General and Pelvic Endoscopic Surgery Products Market

a.   Market Analysis and Segment Growth

b.   Competitive Analysis

v.   Methodology

 

Exhibit ES-1:    Endoscopic Surgery, Procedures Volumes Forecast, 2008-2013

Exhibit ES-2:    2010, Selected Endoscopic Surgery Instrumentation

Exhibit ES-3:    General and Pelvic Endoscopic Surgery Products, Combined Market Forecast, 2008-2013

Exhibit ES-4:    2008, General and Pelvic Endoscopic Surgery Products Market, Share by Segment

Exhibit ES-5:    2013, General and Pelvic Endoscopic Surgery Products Market, Share by Segment

Exhibit ES-6:    2009, Combined General and Pelvic Endoscopic Surgery Products Market, Share by Supplier

 

1. CLINICAL OVERVIEW

1.1 Endoscopic Surgery

1.1.1 Endoscopic Access and a Working Space

1.1.2 Anesthesia

1.1.3 Insufflation

1.1.4 Trocar Insertion

1.1.5 Patient Considerations

1.2 Specialty Procedures

1.3 Advantages, Disadvantages, and Risks

1.3.1 Injuries Associated with Access Needle and Trocar Insertion

1.3.2 Incisional Hernia

1.4 Endoscopic Surgical Products

1.4.1 Access Devices

1.4.1.1 Access Needles

1.4.1.2 Trocars

1.4.2 Access Site Closure Devices

1.4.3 Hand-Assisted Systems

1.4.4 Endoscopes

1.4.5 Endoscopic Video Products

1.4.6 Hand Instruments

1.4.6.1 Clamps and Needle Holders

1.4.6.2 Clip Appliers

1.4.6.3 Forceps

1.4.6.4 Graspers and Retractors

1.4.6.5 Pencils and Dissectors

1.4.6.6 Scissors

1.4.6.7 Staplers

1.4.7 Insufflation Devices

1.4.7.1 Traditional Insufflation

1.4.7.2 Gasless Insufflation

1.4.8 Suction/Irrigation and Fluid Management Systems

1.4.9 Ancillary Devices Used in Endoscopic Surgical Procedures

1.4.9.1 Mechanical Assist Devices

1.4.9.2 Specimen Retrieval Bags

1.4.9.3 Surgical Smoke Evacuation Devices

1.4.10  Surgical Navigation and Robotic Surgical Systems

1.4.11  Emerging Technologies

 

Exhibit 1-1:      2010, Selected Endoscopic Surgery Instrumentation

 

2. ENDOSCOPIC SURGICAL PROCEDURES

2.1 Adrenalectomy

2.1.1 Instrumentation

2.1.2 Surgical Technique

2.2 Appendectomy

2.2.1 Instrumentation

2.2.2 Surgical Technique

2.3 Burch Colposuspension

2.3.1 Instrumentation

2.3.2 Surgical Technique

2.4 Cholecystectomy

2.4.1 Instrumentation

2.4.2 Surgical Technique

2.5 Colectomy

2.5.1 Instrumentation

2.5.2 Surgical Technique

2.6 Cystectomy

2.6.1 Instrumentation

2.6.2 Surgical Technique

2.7 Falloposcopy

2.7.1 Instrumentation

2.7.2 Surgical Technique

2.8 Fundoplication

2.8.1 Instrumentation

2.8.2 Surgical Technique

2.9 Gastroduodenal Ulcer Repair

2.9.1 Instrumentation

2.9.2 Surgical Technique

2.10 Gastroplasty and Gastric Bypass

2.10.1  Instrumentation

2.10.2  Surgical Technique

2.10.2.1 Vertical Banded Gastroplasty

2.10.2.2 Roux-en-Y Gastric Bypass

2.10.2.3 Adjustable Lap Band Bypass

2.11 Hysterectomy

2.11.1  Instrumentation

2.11.2  Surgical Technique

2.12 Hysteromyomectomy

2.12.1  Instrumentation

2.12.2  Surgical Technique

2.13 Hysteroscopy

2.13.1  Instrumentation

2.13.2  Surgical Technique

2.13.2.1 Cryoablation

2.13.2.2 Endometrial Ablation

2.14 Inguinal Herniorrhaphy

2.14.1  Instrumentation

2.14.2  Surgical Technique

2.15 Nephrectomy

2.15.1  Instrumentation

2.15.2  Surgical Technique

2.16 Oophorectomy

2.16.1  Instrumentation

2.16.2  Surgical Technique

2.17 Pelvic Adhesions

2.17.1  Instrumentation

2.17.2  Surgical Technique

2.18 Renal and Ureteral Calculi Management

2.18.1  Instrumentation

2.18.2  Surgical Technique

2.19 Salpingostomy

2.19.1  Instrumentation

2.19.2  Surgical Technique

2.20 Splenectomy

2.20.1  Instrumentation

2.20.2  Surgical Technique

2.21 Transurethral Resection of the Prostate

2.21.1  Instrumentation

2.21.2  Surgical Technique

2.22 Tubal Ligation

2.22.1  Instrumentation

2.22.2  Surgical Technique

2.23 Urethrotomy

2.23.1  Instrumentation

2.23.2  Surgical Technique

2.24 Procedure Volumes Forecast

 

Exhibit 2-1:      Endoscopic Surgery, Procedures Volumes Forecast, 2008-2013

 

3. ENDOSCOPIC ACCESS DEVICES MARKET

3.1 Single-Incision Laparoscopy

3.1.1 Natural Orifice Translumenal Endoscopic Surgery

3.1.2 Market Analysis

3.1.2.1 Covidien

3.1.2.2 Ethicon Endo-Surgery/Johnson & Johnson

3.1.2.3 Olympus America/Olympus

3.1.2.4 Patient Outcomes

3.1.2.5 Economics

3.1.2.6 Consumer Demand

3.2 Types of Access Devices

3.2.1 Access Needles

3.2.1.1 ConMed EndoSurgery/ConMed

3.2.1.2 Autosuture/Covidien

3.2.1.3 Ethicon Endo-Surgery/Johnson & Johnson

3.2.1.4 Medovations

3.2.1.5 Richard Wolf Medical Instruments/Richard Wolf

3.2.1.6 Market Forecast

3.2.1.7 Competitive Analysis

3.2.2 Trocars and Single-Port Access/Incisionless Access Systems

3.2.2.1 Advanced Surgical Concepts/Olympus America/Olympus

3.2.2.2 Applied Medical Resources

3.2.2.3 Aesculap/B. Braun Melsungen

3.2.2.4 Cardinal Health

3.2.2.5 ConMed EndoSurgery/ConMed

3.2.2.6 Autosuture/Covidien

3.2.2.7 Ethicon Endo-Surgery/Johnson & Johnson

3.2.2.8 Olympus America/Olympus

3.2.2.9 Karl Storz Endoscopy-America/Karl Storz

3.2.2.10 SurgiQuest

3.3.2.11 TransEnterix

3.3.2.12 USGI Medical

3.3.2.13 Richard Wolf Medical

              Instruments/Richard Wolf

3.3.2.14 Market Forecast—Trocars

3.3.2.15 Competitive Analysis

3.3.3 Hand-Assisted Laparoscopic Surgery Devices

3.3.3.1 Applied Medical Resources

3.3.3.2 Ethicon Endo-Surgery/Johnson & Johnson

3.3.3.3 Market Forecast

3.3.3.4 Competitive Analysis

 

Exhibit 3-1:      Selected Advantages of Single-Incision/Single-Port Surgery

Exhibit 3-2:      Procedures Employing Single-Incision Laparoscopy

Exhibit 3-3:      Surgical Procedures Being Considered for Single-Incision Laparoscopy,  Procedure Volumes Forecast, 2008-2013

Exhibit 3-4:      Factors Impacting the Adoption of Single-Incision Laparoscopy

Exhibit 3-5:      2010, Selected Access Needles

Exhibit 3-6:      ConMed EndoSurgery’s Insufflation System

Exhibit 3-7:      Medovations’ Hi-Flow Insufflation Needle

Exhibit 3-8:      Richard Wolf Medical Instruments’ Veress Needle

Exhibit 3-9:      Access Needles, Market Forecast, 2008-2013

Exhibit 3-10:    2009, Access Needles Market, Share by Supplier

Exhibit 3-11:    2010, Selected Single-Incision Access Systems

Exhibit 3-12:    Advanced Surgical Concepts/Olympus’ TriPort Multi-Instrument Access Port

Exhibit 3-13:    Advanced Surgical Concepts/Olympus’ QuadPort Multi-Instrument Access Port

Exhibit 3-14:    Applied Medical Resources’ GelPOINT Access Platform

Exhibit 3-15:    Applied Medical Resources’ Premium Disposable Trocar, Kii GelPort Balloon Trocar, and Universal Seal

Exhibit 3-16:    Applied Medical Resources’ Convertible Access System

Exhibit 3-17:    Applied Medical Resources’ Separator  Abdominal Access System

Exhibit 3-18:    Applied Medical Resources’ Fios First Entry  with Spaceguard Technology

Exhibit 3-19:    ConMed EndoSurgery’s CORE Entree Gold  Disposable Trocars and Cannulas

Exhibit 3-20:    Autosuture’s Versaport V2 Conventional Trocar

Exhibit 3-21:    Autosuture’s Versaport Plus Bladeless Trocars

Exhibit 3-22:    Autosuture’s SILS Port Access Device

Exhibit 3-23:    Ethicon Endo-Surgery’s ENDOPATH XCEL Bladeless Trocar

Exhibit 3-24:    SurgiQuest’s AirSeal Dynamic Pressure System

Exhibit 3-25:    Typical Limitations of Traditional Trocar Valve Technology that are Addressed by the AirSeal Dynamic Pressure System

Exhibit 3-26:    SurgiQuest’s AnchorPort Trocar

Exhibit 3-27:    TransEnterix’s SPIDER Surgical System

Exhibit 3-28:    USGI Medical’s Incisionless Operating Platform

Exhibit 3-29:    Richard Wolf Medical Instruments’ RIWO-ART Reusable Trocars

Exhibit 3-30:    Trocars, Market Forecast, 2008-2013

Exhibit 3-31:    2009, Trocars Market, Share by Supplier

Exhibit 3-32:    2010, Selected Hand-Assisted Laparoscopic Surgery Devices

Exhibit 3-33:    Applied Medical Resources’ GelPort Laparoscopic System

Exhibit 3-34:    Ethicon Endo-Surgery’s LAP DISC Hand Access Device

Exhibit 3-35:    Ethicon Endo-Surgery’s DEXTRUS Minimally Invasive Access System with Finger-Mounted Instruments

Exhibit 3-36:    Hand-Assisted Laparoscopic Surgery Devices, Market Forecast, 2008-2013

Exhibit 3-37:    2009, Hand-Assisted Laparoscopic Surgery Devices Market, Share by Supplier

 

4. INSUFFLATION PRODUCTS MARKET

4.1 Products

4.1.1 Aesculap/B. Braun Melsungen

4.1.2 Cardinal Health

4.1.3 LEXION Medical

4.1.4 Olympus America/Olympus

4.1.5 Smith & Nephew

4.1.6 Stryker

4.2 Market Forecast

4.3 Competitive Analysis

 

Exhibit 4-1:      2010, Selected Insufflation Systems

Exhibit 4-2:      Aesculap’s CO2 Insufflator Flow 40 System

Exhibit 4-3:      LEXION Medical’s Insuflow Insufflation System

Exhibit 4-4:      Olympus America’s UHI-3 High Flow Insufflator

Exhibit 4-5:      Olympus America’s UCR Intraluminal Insufflation System

Exhibit 4-6:      Smith & Nephew’s 400 Insufflator

Exhibit 4-7:      Stryker’s PneumoSure 45L Insufflator

Exhibit 4-8:      Insufflation Products, Market Forecast, 2008-2013

Exhibit 4-9:      2009, Insufflation Products Market, Share by Supplier

 

5. ENDOSCOPES MARKET

5.1 Endoscopic Technology

5.2 Flexible Endoscopes

5.3 Rigid Endoscopes

5.4 Endoscopic Video Products

5.5 Types of Endoscopes

5.2.1 Choledochoscopes

5.2.2 Cystoscopes

5.2.3 Duodenoscopes

5.2.4 Falloposcopes

5.2.5 Hysteroscopes

5.2.6 Laparoscopes

5.2.7 Nephroscopes

5.2.8 Resectoscopes

5.2.9 Ureteroscopes

5.2.10 Urethroscopes

5.6 Products

5.6.1 ConMed Linvatec/ConMed

5.6.2 Envisionier Medical Technologies

5.6.3 Fujinon Endoscopy/Fujifilm Holdings

5.6.4 PENTAX/HOYA

5.6.5 Olympus America/Olympus

5.6.6 Smith & Nephew Endoscopy/Smith & Nephew

5.6.7 Karl Storz Endoscopy-America/Karl Storz

5.6.8 Stryker

5.6.9 Richard Wolf Medical Instruments/Richard Wolf

5.7 Market Forecast

5.8 Competitive Analysis

 

Exhibit 5-1:      2010, Selected Endoscopes and Endoscopy Systems

Exhibit 5-2:      Envisionier Medical Technologies’ endogo HD Portable Endoscopic Video Camera

Exhibit 5-3:      Fujinon Endoscopy’s Double Balloon Endoscopy System

Exhibit 5-4:      Fujinon Endoscopy’s Colonoscope, Duodenoscope, and Gastroscope

Exhibit 5-5:      PENTAX’s EC-3890Li Video Colonoscope  and EG-1580K Color Video Gastroscope

Exhibit 5-6:      PENTAX’s EPK-i HD Digital Video and Image Processor

Exhibit 5-7:      Olympus America’s Single Balloon Enteroscopy System

Exhibit 5-8:      Olympus America’s Endo Capsule System

Exhibit 5-9:      Olympus America’s Deflectable-Tip EndoEYE Laparoscope

Exhibit 5-10:    Olympus America’s EndoEYE and HD EndoEYE  Video Laparoscopes

Exhibit 5-11:    Olympus America’s LTF-VH and LTF-VP  Deflectable Tip Laparoscopes

Exhibit 5-12:    Olympus America’s EVIS EXERA II Endoscopic  Video Imaging Platform

Exhibit 5-13:    Representative Images of Olympus America’s Rigid Laparoscopes and Flexible Hysteroscopes

Exhibit 5-14:    Olympus America’s Flexible CYF-5/5A Fiber and CYF-V2/VA2 Video Cystoscopes

Exhibit 5-15:    Smith & Nephew Endoscopy’s 560 Series High Definition Camera System

Exhibit 5-16:    Stryker’s IDEAL EYES Laparoscopes

Exhibit 5-17:    Stryker’s IDEAL EYES HD Articulating Laparoscope

Exhibit 5-18:    Richard Wolf’s eyeMax CCD Cystoscope

Exhibit 5-19:    Endoscopes, Market Forecast, 2008-2013

Exhibit 5-20:    2009, Endoscopes Market, Share by Supplier

 

6. ENDOSCOPIC HAND INSTRUMENTS MARKET

6.1 Types of Endoscopic Hand Instruments

6.2 Products

6.2.1 Aesculap/B. Braun Melsungen

6.2.2 ConMed EndoSurgery/ConMed

6.2.3 Autosuture/Covidien

6.2.4 Ethicon Endo-Surgery/Johnson & Johnson

6.2.5 Olympus America/Olympus

6.2.6 Smith & Nephew

6.2.7 Karl Storz

6.2.8 Stryker

6.2.9 Others

6.2.9.1 Applied Medical Resources

6.2.9.2 Cambridge Endo/Cambridge Endoscopic Devices

6.2.9.3 Encision

6.2.9.4 Novare Surgical Systems

6.3 Market Forecast

6.4 Competitive Analysis

 

Exhibit 6-1:      2010, Selected Endoscopic Hand Instruments

Exhibit 6-2:      Aesculap’s AdTec Bipolar Laparoscopic Hand Instruments

Exhibit 6-3:      Aesculap’s AdTec Needlescopic Mini Modular System

Exhibit 6-4:      Aesculap’s AdTec Needle Holder

Exhibit 6-5:      ConMed EndoSurgery’s Universal Plus Multifunction System

Exhibit 6-6:      Autosuture’s MiniSite MiniShears and MiniPort Introducer System

Exhibit 6-7:      Autosuture’s ENDO GIA Roticular and  MULTIFIRE ENDO GIA 30 Stapler

Exhibit 6-8:      Covidien’s Duet TRS Reload System

Exhibit 6-9:      Ethicon Endo-Surgery’s Harmonic ACE Curved Shears

Exhibit 6-10:    Ethicon Endo-Surgery’s Harmonic ACE Scissor Grip

Exhibit 6-11:    Ethicon Endo-Surgery’s Dextrus Laparoscopic System

Exhibit 6-12:    Smith & Nephew’s Dissecting and Grasping Instruments

Exhibit 6-13:    Smith & Nephew’s Interceptre Laparoscopic Instruments

Exhibit 6-14:    Stryker’s MiniLap Instrument

Exhibit 6-15:    Stryker’s Laparoscopic Instruments

Exhibit 6-16:    Applied Medical Resources’ Direct Drive Laparoscopic Instruments

Exhibit 6-17:    Cambridge Endo’s Autonomy Laparo-Angle Articulating Instruments

Exhibit 6-18:    Encision’s Active Electrode Monitoring Laparoscopic Instruments

Exhibit 6-19:    Novare Surgical Systems’ RealHand High Dexterity Instruments

Exhibit 6-20:    Single-Port Laparoscopic Procedures that Utilize RealHand High Dexterity Instruments

Exhibit 6-21:    Endoscopic Hand Instruments, Market Forecast, 2008-2013

Exhibit 6-22:    2009, Endoscopic Hand Instruments Market, Share by Supplier

 

7. ENDOSCOPIC ACCESS SITE CLOSURE PRODUCTS MARKET

7.1 Products

7.1.1 Autosuture/Covidien

7.1.2 CooperSurgical

7.1.3 Ethicon/Johnson & Johnson

7.1.4 Paré Surgical

7.1.5 Orthovita

7.1.6 Richard Wolf Medical Instruments/Richard Wolf

7.2 Market Forecast

7.3 Competitive Analysis

 

Exhibit 7-1:      2010, Selected Endoscopic Access Site Closure Products

Exhibit 7-2:      Autosuture’s Endo Close Trocar Site Closure Device

Exhibit 7-3:      Autosuture’s Endo Stitch Suturing Device

Exhibit 7-4:      CooperSurgical’s CT CloseSure System

Exhibit 7-5:      Paré Surgical’s gi-STITCH Flexible Endoscopic Suturing System

Exhibit 7-6:      Paré Surgical’s Quik-Stitch Endoscopic Suturing System

Exhibit 7-7:      Orthovita’s Vitagel Surgical Hemostat

Exhibit 7-8:      Richard Wolf Medical Instruments’ Fascial Closure Kit

Exhibit 7-9:      Endoscopic Access Site Closure Products, Market Forecast, 2008-2013

Exhibit 7-10:    2009, Endoscopic Access Site Closure Products Market, Share by Supplier

 

8. ROBOTIC ASSISTED MINIMALLY INVASIVE SURGERY MARKET AND SURGICAL NAVIGATION SYSTEMS

8.1.1 Robotic-Assisted Surgical Systems

8.1.1.1 Curexo Technology

8.1.1.2 Intuitive Surgical

8.1.2 Surgical Navigation Systems

8.1.2.1 BrainLAB

8.1.2.2 GE Healthcare/General Electric

8.1.2.3 MediGuide/St. Jude Medical

8.1.2.4 Medtronic

8.1.2.5 Olympus America/Olympus

8.1.2.6 Stryker

8.1.2.7 Visionsense

8.1.3 Market Forecast—Robotic-Assisted Surgery

8.1.3.1 Emerging Technology

 

Exhibit 8-1:      2010, Selected Robotic-Assisted Surgical Systems and Surgical Navigation Systems

Exhibit 8-2:      Selected Procedures Facilitated by the da Vinci Surgical System

Exhibit 8-3:      Intuitive Surgical’s da Vinci S HD Surgical System

Exhibit 8-4:      Intuitive Surgical’s da Vinci Si HD Surgical System

Exhibit 8-5:      Intuitive Surgical’s EndoWrist Instrument

Exhibit 8-6:      Selected Screenshot of the BrainLAB Knee Essential Software

Exhibit 8-7:      GE Healthcare’s InstaTrak 3500 Plus Surgical Navigation System

Exhibit 8-8:      Medtronic’s FUSION Electromagnetic ENT Navigation System

Exhibit 8-9:      Olympus America’s ScopeGuide Mobile Imaging System

Exhibit 8-10:    Stryker’s iNtellect ENT Navigation Software and InfraVision Imaging System

Exhibit 8-11:    Visionsense’s VSII Stereoscopic Vision System

Exhibit 8-12:    2009, Intuitive Surgical’s Financial and Procedural Growth

Exhibit 8-13:    Procedures that Employ Intuitive Surgical’s  da Vinci Surgical System

Exhibit 8-14:    Targeted Procedures for which the da Vinci  Surgical System May Be Employed

Exhibit 8-15:    Robotic-Assisted Minimally Invasive Surgical Systems,            Market Forecast, 2008-2013

 

9. COMPANY PROFILES

9.1       Advanced Surgical Concepts

9.2       Applied Medical Resources Corporation

9.3       ConMed EndoSurgery/ConMed Corporation

9.4       Covidien PLC

9.5       Fujinon Endoscopy/Fujifilm Holdings Corporation

9.6       Intuitive Surgical, Inc.

9.7       Johnson & Johnson

9.8       Olympus America, Inc./Olympus Corporation

9.9       Smith & Nephew PLC

9.10     Karl Storz GmbH & Co. KG

9.11     Stryker Endoscopy/Stryker Corporation

9.12     SurgiQuest, Inc.

9.13     TransEnterix, Inc.

9.14     USGI Medical, Inc.

9.15     Richard Wolf GmbH

 

APPENDIX:  COMPANY LISTING

 

 

 

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