New applications of technology, as well as innovations in technology itself are prompting market expansion.

Endoscopy technology has changed the manner of detecting diseases and performing surgeries, with less invasive methods that are gaining attention across the globe. Technological advancements, such as accurate visibility, high-definition imaging and documentation, and more could command strong market growth. The global endoscopy device market is expected to reach USD 45.2 billion by 2020, reflecting a five-year compound annual growth rate (CAGR) of 6.8 percent.

Trends, such as the combining and merging of different imaging and visualization methods – like MRI or CT with endoscopic images – or the connection and integration of medical devices in the operating theater, as well as combining endoscopic visualization with instruments, lasers, and other devices and technologies, will push further developments in this area.

Advancements in technology like increased angles in the field of view in endoscopes; reduced outer diameter of scopes; endoscopy systems that are integrated with high-resolution technologies such as 3-D systems; capsule endoscopes; and miniaturized endoscopy systems as well as new innovations in the technology itself, are expected to encourage market expansion in coming years.

Technology Update

Trends such as the combining and merging of different imaging and visualization methods – like MRI or CT with endoscopic images – or the connection and integration of medical devices in the operating theater, as well as combining endoscopic visualization with instruments, lasers, and other devices and technologies, will push further developments in this area.

The full scope. In recent years, the field of endoscopy has seen a variety of innovations. "One of the major turning points has been the start of robotic surgery with Intuitive Surgical's da Vinci robotic system. Besides its robotic arms, the system has a 3-D-imaging system. 3-D is very popular today, and is now offered in a handheld system in the form of the Aesculap EinsteinVision. Along with lightweight chip-in-scope technology, the second generation of EinsteinVision systems can also be used with EndoSheath microbial barriers, which allow the endoscope to become a permanent fixture in the operating theater as a part of the endoscope tower, reducing the volume of capital equipment that moves around in a hospital," elucidates Dr Claas Mller, managing director of the Chair of Process Technology, Department of Microsystems Engineering (IMTEK), at the University of Freiburg, Germany.

Chip-in-scope and LED-in-scope, together with full-HD image sensors, offer new possibilities in the endoscopic field. In addition to making the instrument a lightweight hand-piece with a single cable, the system does not require any additional or separate light sources or cables. For applications where full HD resolution is not required, the sensor can be integrated into the distal tip of the endoscope (chip-in-tip endoscope). A disposable endoscope may be the preferred solution in the near future for applications where a difficult-to-reprocess working channel is necessary.

Similarly to the consumer market, 4K resolution is also offered in medical endoscopy, although it is yet to be discussed whether this expensive technology offers any real advantage. Today, endoscopic towers are usually equipped with a 27–32 inch monitor, and for the human eye to see 4K resolution in a 32-inch monitor, the distance between eye and monitor should be around 60 cm. This distance is generally not practical, due to the fact that the display has to be positioned in the sterile field above the patient. Additionally, 4K only makes sense when the full chain – from the endoscope and its sensor in the camera head to the video on the monitor – is realized in 4K. At the moment, therefore, 4K will be strictly a high-end solution for customers that can afford a 50 inch-plus monitor in the operating theater. Together with 4K, an extended color space (BT2020, as opposed to BT709) will be introduced. Fortunately, this extended color space will also be offered shortly with full HD monitors. Modern full-HD cameras will also be able to offer this extended wide-range color space for endoscopic procedures at minimal extended cost for 27–32 inch monitors.

Assisting algorithms. Today, endoscopic visualization is significantly influenced by video algorithms that are usually part of the camera head and/or camera control unit. The goal of using such algorithms in endoscopic camera settings is to improve the image quality automatically to give the user the best performance. One of the biggest problems in the past for end users was the need to deal with defective pixel errors of the image sensor, which can be caused by issues such as cosmic radiation during shipment in an aircraft. Such errors can be disrupting and may interfere with a procedure. Modern cameras are equipped with dynamic pixel-error detection and correction that eliminate such pixel errors continuously.

Significant image improvement can also be seen from using a dynamic contrast algorithm, which provides the surgeon with a more vivid image. One feature of the algorithm is that it recognizes the active image size of the endoscope automatically. This area can be used by additional algorithms for brightness and image optimization. The image can also be centered on the screen and automatically zoomed to the requested level. With new endoscope technologies such as chip-in-tip or chip-in-scope, further algorithms can compensate for optical issues such as distortion and vignetting. The surgeon will have the advantage of getting a more realistic image of the best quality in full-screen mode without reduction of brightness and sharpness to the edges that, in the past, was only available in high-price endoscopes and optical systems.

Way Forward

As the market progresses, there will be a clear differentiation of endoscopic systems due to the requirements of reprocessing and image-quality procedures. Trends are already visible from expensive optical high-end endoscopes toward optimized visualization systems that integrate endoscope and camera. Such significant changes in many minimally invasive applications continue to provide new opportunities for all system providers and require competent partners to develop new products.

System providers will ask for optimized solutions including instruments, lasers or other medical devices. For such customized solutions, medical device manufacturers will continue to cooperate with companies that have expertise in the development and manufacture of endoscopes and camera technologies, as well as in image processing.

One strategy for manufacturers is to combine standard and private-label products. This allows them to immediately start with endoscopic products using their logo and brand without investing heavily in R&D, thereby avoiding long development times and costs. Furthermore, if manufacturers respond promptly to market feedback on first-generation products, they can start on a customized second generation of OEM products within a very short time, forging the path for significant advances in endoscopy.


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