Home » Healthcare » Endoscopic Submucosal Dissection (ESD) Market

Endoscopic Submucosal Dissection (ESD) Market By Product (Knives, Tissue Retractors, Grasp/Clips, Injecting Agents, Gastroscopes & Colonoscopes); By Indication (Esophageal Cancer, Stomach Cancer, Colon Cancer); By End User (Hospitals, Ambulatory Surgical Centers, Specialty Clinics); By Region – Growth, Share, Opportunities & Competitive Analysis, 2024 – 2032

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Published: | Report ID: 37490 | Report Format : PDF
Historical Period  2019-2022
Base Year  2023
Forecast Period  2024-2032
Endoscopic Submucosal Dissection (ESD) Market Size 2023  USD 309.92 Million
Endoscopic Submucosal Dissection (ESD) Market, CAGR  6.96%
Endoscopic Submucosal Dissection (ESD) Market Size 2032  USD 637.42 Million

Market Overview:

The global endoscopic submucosal dissection (ESD) market is projected to experience steady growth, reaching an estimated USD 637.42 million by 2032 from USD 309.92 million in 2023, reflecting a CAGR of 6.96%.

The endoscopic submucosal dissection (ESD) market is driven by several factors, including the rising incidence of gastrointestinal diseases such as early-stage cancers, precancerous lesions, and large polyps. This trend fuels the demand for minimally invasive procedures like ESD, which offer effective treatment options with reduced patient discomfort and faster recovery times. Moreover, continuous technological advancements in endoscopic instruments and techniques enhance the precision and safety of ESD procedures, contributing to wider adoption, particularly among the aging population who are more susceptible to gastrointestinal conditions.

Geographically, the market shows diverse dynamics. In Asia-Pacific, the region is poised to experience the fastest growth due to factors such as a rising elderly population, increasing healthcare awareness, and growing investments in medical infrastructure. North America boasts a significant market size, attributed to established healthcare systems and high adoption rates of advanced technologies. Meanwhile, in Europe, stringent regulatory frameworks and established healthcare systems influence market growth patterns in the region. Key players in the market, including Fujifilm Holdings Corporation, Olympus Corporation, Boston Scientific Corporation, Hoya Corporation, and Erbe Elektromedizin GmbH, are actively contributing to advancements and innovations in the field, fostering competition and driving the market forward.

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Market Drivers:

Escalating Prevalence of GI Diseases and Tumors:

One of the primary drivers behind the surge in the endoscopic submucosal dissection (ESD) market is the increasing prevalence of gastrointestinal (GI) diseases and early-stage tumors. For instance, according to the World Health Organization, gastric cancer is the third leading cause of cancer death worldwide, with an estimated 1.03 million new cases in 2020. Conditions like esophageal cancer, gastric cancer, and colonic neoplasms are becoming more prevalent, partly due to enhanced diagnostic techniques and heightened awareness leading to earlier detection. Consequently, there is a growing demand for minimally invasive treatment options like ESD, which allows for the removal of early-stage GI tumors with improved patient outcomes.

Advantages of Minimally Invasive Approach:

ESD offers several advantages over traditional surgical methods for removing early-stage GI tumors, attracting both patients and physicians towards its adoption. For instance, a study published in the Journal of Gastroenterology and Hepatology found that patients who underwent ESD had a significantly shorter hospital stay (mean 7.3 days) compared to those who underwent surgery (mean 14.6 days). These benefits include reduced hospital stays, faster recovery times, lower risk of complications, and better cosmetic outcomes. As patients and healthcare professionals recognize these advantages, the demand for ESD continues to rise, driving market growth in the GI endoscopic segment.

Technological Advancements in Endoscopic Technology:

Significant advancements in endoscopic technology and techniques are playing a pivotal role in expanding the ESD market. For instance, the introduction of Narrow Band Imaging (NBI) has improved the detection of early-stage GI tumors. Innovations such as high-definition endoscopes providing clearer views, enhanced maneuverability of instruments allowing for greater control during dissection, and the development of specialized ESD instruments are continuously improving the efficacy and safety of ESD procedures. These technological enhancements make ESD a more appealing treatment option for both medical professionals and patients, contributing to the growth of the market.

Demographic Trends and Healthcare Expenditure:

The aging global population is driving an increased demand for minimally invasive procedures like ESD, as older individuals are more prone to GI diseases and tumors. Moreover, rising healthcare expenditure worldwide, particularly in emerging economies, along with the implementation of reimbursement policies for ESD procedures by some governments and insurance companies, is expected to further boost market growth. These factors collectively create a favorable environment for the continued expansion of the ESD market in the foreseeable future.

Market Trends:

Expanding Applications in Early-Stage Cancers:

Endoscopic Submucosal Dissection (ESD) is increasingly being adopted as a primary intervention for early-stage gastrointestinal cancers. For instance, gastric cancer, with nearly one million incident cases annually globally, is the third leading cause of global cancer mortality. Early Gastric Cancer (EGC) accounts for 15 to 57 percent of incident gastric cancer. The 5-year relative survival rates for different stages of stomach cancer are: 75% for localized stomach cancer (cancer is in the stomach only), 35% for regional stomach cancer (cancer has spread beyond the stomach to nearby lymph nodes or organs), and 7% for metastatic stomach cancer (cancer has spread beyond the stomach to a distant part of the body). ESD’s ability to achieve en bloc resections and minimize recurrence rates is driving its preference over traditional surgery for these cases. This trend is expected to continue, fueling market growth.

Rising Focus on Minimally Invasive Procedures:

Patients and healthcare providers alike are seeking minimally invasive procedures whenever possible. For example, the use of robotic surgery for all general surgery procedures increased from 1.8% to 15.1% from 2012 to 2018. Neuromodulator injections and dermal fillers emerged as favorites, experiencing a nearly two-fold increase since 2019. ESD offers a less invasive alternative to traditional surgery, resulting in faster recovery times, reduced pain, and improved patient outcomes. This focus on minimally invasive approaches is propelling the adoption of ESD and consequently, the market.

Market Challenges Analysis:

Technical Complexity and Steep Learning Curve:

ESD is a technically demanding procedure requiring significant training and expertise from endoscopists. It involves precise manipulation of specialized instruments within a confined anatomical space. Mastering the technique necessitates extensive training, including animal models and supervised clinical practice. This high barrier to entry limits the number of qualified practitioners who can perform ESD effectively, especially in regions with limited access to training programs.

High Cost of Equipment and Procedures:

The ESD procedure utilizes specialized endoscopic instruments like high-resolution scopes, electrosurgical units, and various grasping and dissecting tools.  These advanced instruments contribute to the overall cost of the procedure. Additionally, the extended duration and technical complexity of ESD often translate to higher operating room time and resource utilization, further increasing the overall cost.  Limited reimbursement policies in certain healthcare systems may create a financial burden for patients, hindering wider accessibility.

Segmentation Analysis:

By Product:

The knives segment holds the dominant market share in the endoscopic submucosal dissection (ESD) market, primarily due to their critical role in the precise dissection of lesions during ESD procedures. Advancements in knife technology, including specialized ESD knives, are further fueling growth in this segment. Meanwhile, the other products segment encompasses a range of equipment such as gastroscopes, colonoscopes, injection agents, tissue retractors, and graspers/clips. Growth in this segment is expected to be steady, driven by the increasing demand for complete ESD procedural kits and the need for advanced visualization and support equipment, thus contributing to the overall expansion of the ESD market.

By Indication:

Endoscopic Submucosal Dissection (ESD) is a vital minimally invasive procedure used in the treatment of various types of cancer, with stomach cancer currently holding the largest market share, exceeding 63% in 2022. The prevalence of stomach cancer, especially in specific regions, drives the demand for ESD procedures, particularly for early-stage tumors and precancerous lesions. Additionally, ESD plays a significant role in managing early-stage colon cancer and large polyps, with the market share expected to grow steadily due to the rising incidence of colorectal cancer. Moreover, ESD offers a minimally invasive treatment option for early-stage esophageal cancer and high-grade dysplasia, although its market share is smaller compared to stomach and colon cancer. Nevertheless, advancements in ESD techniques and increasing awareness of this procedure are anticipated to drive its growth in the coming years.

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Based on Product

  • Knives
  • Tissue Retractors
  • Grasp/Clips
  • Injecting Agents
  • Gastroscopes & Colonoscopes

Based on Indication

  • Esophageal Cancer
  • Stomach Cancer
  • Colon Cancer

Based on End User

  • Hospitals
  • Ambulatory Surgical Centers
  • Speciality Clinics

Based on Region

  • North America
    • The U.S.
    • Canada
    • Mexico
  • Europe
    • Germany
    • France
    • The U.K.
    • Italy
    • Spain
    • Rest of Europe
  • Asia Pacific
    • China
    • Japan
    • India
    • South Korea
    • South-east Asia
    • Rest of Asia Pacific
  • Latin America
    • Brazil
    • Argentina
    • Rest of Latin America
  • Middle East & Africa
    • GCC Countries
    • South Africa
    • The Rest of the Middle East and Africa

Regional Analysis:


Europe follows North America in market share, capturing around 30% of the global market. Similar factors, such as a robust healthcare system, a growing geriatric population susceptible to gastrointestinal diseases, and increasing awareness of minimally invasive procedures, contribute to Europe’s significant market share.

Asia Pacific:

The Asia Pacific region is expected to witness the fastest growth in the coming years. This can be attributed to factors like rising disposable income, increasing awareness of advanced endoscopic techniques, and a large and aging population with a high prevalence of gastrointestinal diseases. However, the current market share of Asia Pacific is estimated to be around 25%, due to limitations in healthcare infrastructure and lower rates of early diagnosis in some countries.

Key player:

  • Olympus Corporation
  • Boston Scientific Corporation
  • FUJIFILM Holdings Corporation
  • Sumitomo Bakelite Co. Ltd.
  • Creo Medical PLC
  • MTW-Endoskopie W.Haag KG
  • Ovesco Endoscopy AG
  • CONMED Corporation
  • Micro-Tech Endoscopy

Competitive Analysis:

The endoscopic submucosal dissection (ESD) market exhibits a moderately competitive landscape with established players like Olympus, Fujifilm, and Boston Scientific holding significant market share. These companies focus on continuous product innovation, offering advanced ESD knives, electrosurgical generators, and visualization systems. Emerging players like Creo Medical and Micro-Tech Endoscopy are challenging the status quo with their disruptive technologies and competitive pricing models. This dynamic environment fosters ongoing research and development, ultimately benefiting patients through improved treatment options and potentially lower costs.

Recent Developments:

In October,2023, Fujifilm has recently announced the expansion of their endoscopy solutions for gastroenterology applications like Endoscopic Submucosal Dissection (ESD). The latest enhancements to their product lineup include a range of tools including improved integrated imaging technologies and advanced endoscopic blades. Furthermore, the advancements also focus on offering a suite of cost-efficient solutions that are designed to meet the professional needs of gastroenterologists. With these improvements, practitioners can now expect expanded procedural capabilities that include higher efficiency and better visualization when performing ESD procedures. This new product assortment is sure to be a great asset for any medical center looking to bolster their endoscopic offerings and provide better care for their patients.

In March 2023, Agilis Robotics Ltd. completed its first mainland China test, validating the feasibility and versatility of its robotic instruments for endoscopic surgery. Surgeons simulated training and successfully performed endoscopic submucosal dissection and en bloc resection of a bladder tumor. Top of Form

In February 2023, Mediclinic Parkview Hospital launched endoscopic submucosal dissection (ESD) services, offering a less invasive alternative for patients who would have otherwise needed surgical interventions, such as esophageal, colon, or stomach resection.

In August,2022,  Olympus is proud to announce their expansion of the exclusive partnership with Endoclot Plus, Inc. to provide the European, Middle Eastern and African (EMEA) markets with significant advances in endoscopic submucosal dissection tissue management using proprietary bipolar-discharge technology. Olympus has been leading the industry in developing innovative products for over a century, and this latest venture is yet another example of this forward-thinking progress. With Endoclot’s cutting-edge product strategy, customers will now have access to the highest quality endoscopy products available on the market. This combination of Olympus’ decades of experience paired with Endoclot’s mission to optimize tissue resection performance stands to bring about unprecedented outcomes for EMEA patients seeking advanced treatments for gastrointestinal illnesses.

Market Concentration & Characteristics:

The endoscopic submucosal dissection market exhibits a relatively concentrated landscape with a few leading players dominating the market share. These established companies possess significant technological expertise and resources, allowing them to drive innovation and development in the field. However, smaller, niche players are also emerging, contributing to the advancement of specialized endoscopic submucosal dissection technologies and catering to specific clinical needs. This dynamic fosters a mix of competition and collaboration, ultimately propelling the market forward.

Report Coverage:

The research report offers an in-depth analysis based on Product, Indication, End Use, and Region. It details leading market players, providing an overview of their business, product offerings, investments, revenue streams, and key applications. Additionally, the report includes insights into the competitive environment, SWOT analysis, current market trends, as well as the primary drivers and constraints. Furthermore, it discusses various factors that have driven market expansion in recent years. The report also explores market dynamics, regulatory scenarios, and technological advancements that are shaping the industry. It assesses the impact of external factors and global economic changes on market growth. Lastly, it provides strategic recommendations for new entrants and established companies to navigate the complexities of the market.

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Future Outlook:

  1. The growing prevalence of gastrointestinal (GI) cancers and precancerous lesions is expected to fuel demand for minimally invasive procedures like ESD.
  2. Continued advancements in endoscopic technology, with features like improved visualization and instrument design, will enhance the efficacy and safety of ESD procedures, expanding its application.
  3. The aging population is more susceptible to GI diseases, creating a larger patient pool for ESD procedures.
  4. Rising awareness among healthcare professionals and patients regarding ESD as a minimally invasive alternative to surgery will drive market growth.
  5. The growing preference for minimally invasive procedures due to faster recovery times and reduced patient discomfort will benefit the ESD market.
  6. Continued efforts by medical device manufacturers to secure wider insurance coverage for ESD procedures will improve patient access and market expansion.
  7. The introduction of innovative ESD devices with improved functionalities, such as increased maneuverability and tissue grasping capabilities, will enhance procedure efficiency and adoption.
  8. Increased focus on training programs for gastroenterologists and endoscopists to develop expertise in ESD techniques will be crucial for market growth.
  9. Rising healthcare expenditure and increasing awareness of advanced medical procedures in emerging economies present significant growth opportunities for the ESD market.
  10. Potential integration of artificial intelligence (AI) for real-time lesion characterization and procedural guidance during ESD procedures could revolutionize the market in the long run.

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Frequently Asked Questions:

What is the current size of the ESD Market?

The ESD market was valued at USD 309.92 million in 2023 and is projected to reach USD 637.42 million by 2032, with a compound annual growth rate (CAGR) of 6.96%.

What factors are driving the growth of the ESD market?

Several factors are propelling the growth of the ESD market, including the rising incidence of gastrointestinal diseases such as early-stage cancers, precancerous lesions, and large polyps, technological advancements improving the precision and safety of ESD procedures, the growing geriatric population, and the preference for minimally invasive treatment options.

What are the key segments within the ESD market?

The key segments within the ESD market include stomach cancer, colon cancer, and esophageal cancer. These segments represent different indications for which ESD procedures are utilized.

What are some challenges faced by the ESD market?

Challenges in the ESD market may include regulatory hurdles, especially in regions with stringent approval processes, the learning curve associated with adopting advanced ESD techniques, and the need for continuous innovation to address evolving patient needs and preferences.

Who are the major players in the ESD Market?

Major players in the ESD market include Fujifilm Holdings Corporation, Olympus Corporation, Boston Scientific Corporation, Hoya Corporation, and Erbe Elektromedizin GmbH. These companies are at the forefront of developing and supplying ESD devices and technologies.

Which segment is leading the market share?

Currently, the stomach cancer segment holds the largest market share within the ESD market, accounting for over 63% in 2022. This dominance is attributed to the high prevalence of stomach cancer and the demand for minimally invasive ESD procedures for early-stage tumors and precancerous lesions.

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