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Feature article
Within Europe, rigid endoscopes are still a potentially exciting clinical area where both new and existing competitors are fighting hard for market
share. Although this market is seen as becoming saturated, the drive to develop new technologies and new procedures continues. In addition, growing
restrictions on pricing and a tough competitive environment make this a challenging area where competitors will need to pull out all the stops to win
market share.
Minimally invasive surgery is a well-accepted technique, and rigid endoscopy is considered to be a mature market within Europe. The larger, most
established clinical areas such as laparoscopy, urology and arthroscopy have reached a state of steady growth, although the search for new procedures
for rigid endoscopes within all these areas goes on. One example of this is arthroscopic procedures in difficult anatomies such as the shoulder and
wrist. Companies such as Atlantech have been able to build up this niche market by developing rigid endoscopes with a wider field of vision that allow
the area to be observed with a single optic. Newer applications, such as neuroendoscopy, have shown much faster growth rates as new procedures become
possible and new regions of the body become accessible. Growth rates for increases in the number of neuroendoscopy procedures are believed to be in
the region of 7-15% a year.
Market Segment Opportunities
Laparoscopy
- A large market where growth has slowed as the market has matured.
Urology
- A large, well established market where new technology may increase revenue growth through price increases.
Gynaecology
- A large, well established market where new technology may increase revenue growth through price increases.
ENT Paediatric
- ENT is one area where doctors are developing new techniques.
Arthroscopy
- Newer procedures treating difficult areas such as the shoulder and ankle are experiencing faster growth.
Neuroendoscopy
- The fastest growing market for rigid endoscopes.
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Neuroendoscopy promises to take rigid endoscopic techniques to a new level. The central nervous system poses challenges to minimally invasive
surgery including:
- The use of gas insufflation or fluid perfusion to optimise the field of vision (as is done in conventional endscopic procedures) is not possible
because of the likelihood of damage
- Minor bleeding can be catastrophic
- Utter sterility is a pre-requisite
This has created the need for instruments that are specifically designed for use in the CNS. Examples of new procedures that have become possible
involving the use of rigid endoscopes in neuroendoscopy include:
- Treatment of hydrocephalus (third ventriculostomy and fenestration)
- Removal of tumours and cysts
- Evacuation of some types of subdural haematomas (chronic and multilocated)
- Placement of shunt catheters
- Treatment of aneurysms
- Treatment of sympathetic mediated pain
- Endoscopic procedures on the CNS of children and infants
The rigid endoscopy market as a whole, has been dominated by a few, large competitors such as Karl Storz, Richard Wolf, Olympus and Smith and
Nephew for several years. Other companies such as Stryker have a built up a significant presence in many European markets, where the company has made
inroads into the arthroscopy market in particular. New competitors, from within Europe, the US and Asia have begun to gain a foothold in some of the
larger European regions such as Germany, but for the foreseeable future the current market structure is unlikely to show dramatic changes. Brand and
regional loyalty are still important in Europe and established competitors have built up strong customer relationships and continue to be regarded as
providers of high quality equipment. In Germany in particular, the label " made in Germany" continues to be seen as a vital sales
tool. | 
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