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									              Surgical Equipment Market to 2016 - Emerging Economies
                         to Provide Future Growth Opportunities
            Reference Code: GBIME0009MR                                                                                   Publication Date: JUN 2010

         The global market for              The Global Surgical Equipment Market to Exceed $7 billion by 2016
         surgical equipment is
         forecast to exceed $7               Surgical Equipment, Global, Overall Revenues ($ billion), 2009 – 2016
         billion by 2016 with a
         CAGR of 6% from 2009 to                                           15
         2016.


                                                                           12
                                                    Revenues ($ billion)




                                                                           9


                                                                                                6%
                                                                           6




                                                                           3




                                                                           0
                                                                                2009                                      2016


                                             Source: GBI Research



                                            The global market for surgical equipment is forecast to exceed $7 billion by 2016 with a Compound
                                            Annual Growth Rate (CAGR) of 6% from 2009 to 2016. The market is expected to be driven by
                                            strong economic growth forecasts in emerging economies such as China and India leading to
                                            increased investments in healthcare infrastructure, growing demand for outpatient surgeries,
                                            technological advances in surgical equipment, increasing preference for minimally invasive
                                            surgeries and an aging population.
                                            Emerging Economies due to their Strong Economic Growth Forecasts to be the Growth
                                            Engines of the Future
                                            Emerging economies such as India and China are forecast to grow in excess of 8% for the next two
                                            years. Brazil which had muted growth in 2009 is forecast to grow in excess of 5% in 2010. The
                                            strong economic growth forecasts in emerging economies such as India and China are expected to
                                            lead to increased investments in healthcare infrastructure, high patient affordability, expansion of
                                            healthcare insurance in China and India and an improvement in healthcare services offered. Also
                                            China and India are the most populated countries in the world which should provide significant
                                            growth opportunities for years to come.




Surgical Equipment Market to 2016 - Emerging Economies to Provide                                                   GBIME0009MR /Published JUN 2010
Future Growth Opportunities
                                                                                                                                                  Page 1
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                                            The US is the Biggest Market for Surgical Equipment

                                             Surgical Equipment, Geographic Contribution (%), 2009
         The US is the biggest
         market     for    surgical
         equipment,     contributing
         36% towards the global
         market in 2009                                                                                                       US, 36%




                                                                    Other Countries,
                                                                          64%




                                             Source: GBI Research



                                            The US is the biggest market for surgical equipment, contributing 36% towards the global market in
                                            2009. The value of this share in 2009 was $1.7 billion which is forecast to grow at a CAGR of 5% to
                                            reach $2.4 billion by 2016. However the contribution of the US towards the global market is
                                            expected to decline to 32% by 2016. Factors such as higher surgical equipment market growth in
                                            Japan, Europe and the emerging economies, healthcare reforms and declining reimbursement
                                            levels in the US are expected to lead to a decline in the contribution.
                                            Ethicon is the Leading Company in the Global Surgical Equipment Market

                                             Surgical Equipment, Global, Company Share (%), 2009




                                                                                                                                Ethicon, 35%




                                                        Other Companies,
                                                              65%




                                             Source: GBI Research



                                            In 2009, Ethicon with a 35% share was the leader in the global surgical equipment market. This
                                            market dominance can be attributed to its major presence in the surgical sutures market, which is
                                            the largest category in the surgical equipment market, and the wide range of surgical equipment
                                            the company offers to its clients (including hospitals, clinics and outpatient centers). In addition,
                                            Johnson & Johnson, the parent company of Ethicon, exerts a great deal of influence on Group
                                            Purchasing Organizations (GPOs) especially in the US.




Surgical Equipment Market to 2016 - Emerging Economies to Provide                                                       GBIME0009MR /Published JUN 2010
Future Growth Opportunities
                                                                                                                                                      Page 2
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                                            Surgical Sutures to Continue to be the Largest Category in the Global Surgical Equipment
                                            Market
                                            In 2009, the surgical sutures contribution towards the global surgical equipment market was 56%.
                                            This contribution is forecast to increase to 59% by 2016. The global market for surgical sutures was
                                            valued at $2.65 billion in 2009, and is forecast to grow at a CAGR of 7% to reach $4.3 billion in
                                            2016. The market is expected to be driven by an increasing number of surgical procedures and
                                            technological advances in surgical sutures. In 2009, about 100 million surgical incisions were
                                            performed. Around 80 million wounds use some form of closure product such as sutures. Surgical
                                            wounds are forecast to increase at an annual growth rate of 3% for the next three to five years. The
                                            demographics and disease trends clearly point to an increase in the number of surgeries to be
                                            performed.




Surgical Equipment Market to 2016 - Emerging Economies to Provide                                               GBIME0009MR /Published JUN 2010
Future Growth Opportunities
                                                                                                                                              Page 3
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                                            1 Table of Contents
                                            1   Table of Contents ........................................................................................................................ 4
                                                1.1    List of Tables..................................................................................................................... 7
                                                1.2    List of Figures ................................................................................................................... 8
                                            2   Introduction.................................................................................................................................. 9
                                                2.1    GBI Research Guidance ................................................................................................... 9
                                            3   Surgical Equipment: Market Characterization............................................................................ 10
                                                3.1    Global Surgical Equipment Market, Revenue ($ billion), 2002 – 2009 ............................ 10
                                                3.2    Global Surgical Equipment Market, Revenue Forecast ($ billion), 2009 – 2016 ............ 11
                                                3.3    Global Surgical Equipment Market, Key Trends ............................................................. 12
                                                   3.3.1    Electrical Plasma is a Trend in Electrosurgery that is Expected to find Increased
                                                            Adoption by Surgeons ............................................................................................. 12
                                                   3.3.2    Focus on Comparative Effectiveness and Reference Pricing to be a Norm in the
                                                            Future ...................................................................................................................... 14
                                                   3.3.3    Increasing Demand for Minimally Invasive Surgeries is Favorably Impacting
                                                            Electrosurgical Devices ........................................................................................... 15
                                                3.4    Surgical Equipment, Market Dynamics ........................................................................... 16
                                                   3.4.1    Market Drivers ......................................................................................................... 16
                                                   3.4.2    Market Restraints .................................................................................................... 21
                                                3.5    Global Surgical Equipment Market, Key Company Share (%), 2009 .............................. 23
                                            4   Global Surgical Equipment Market: Category Analysis and Forecasts...................................... 24
                                                4.1    Surgical Sutures.............................................................................................................. 24
                                                4.2    Surgical Sutures Market, Global, Revenue ($ billion), 2002 – 2009................................ 25
                                                4.3    Surgical Sutures Market, Global, Revenue Forecast ($ billion), 2009 – 2016 ................. 26
                                                4.4    Surgical Sutures: Market Dynamics ................................................................................ 27
                                                   4.4.1    Market Drivers ......................................................................................................... 27
                                                   4.4.2    Market Restraints .................................................................................................... 29
                                                4.5    Surgical Sutures Market, Global, Company Shares (%), 2009 ....................................... 30
                                                4.6    Hand Instruments............................................................................................................ 33
                                                4.7    Hand Instruments Market, Global, Revenue ($ billion), 2002 – 2009.............................. 34
                                                4.8    Hand Instruments Market, Global, Revenue Forecast ($ billion), 2009 – 2016 .............. 35
                                                4.9    Hand Instruments: Market Dynamics .............................................................................. 36
                                                   4.9.1    Market Driver: Growing Patient, Healthcare Professional and Healthcare Payor
                                                            Demand for Minimally Invasive Surgeries to Positively Impact Market Growth ....... 36
                                                   4.9.2    Market Restraint: Long Life of Hand Instruments and Improvements in Sterilization
                                                            Techniques is Slowing the Market Growth .............................................................. 36
                                                4.10 Hand Instruments Market, Global, Company Shares (%), 2009 ..................................... 37
                                                4.11 Electrosurgical Devices................................................................................................... 37
                                                4.12 Electrosurgical Devices Market, Global, Revenue ($m), 2002 – 2009 ............................ 38
                                                4.13 Electrosurgical Devices Market, Revenue Forecasts ($m), 2009 – 2016........................ 39
                                                4.14 Electrosurgical Devices: Market Dynamics ..................................................................... 40
                                                   4.14.1 Market Drivers ......................................................................................................... 40
                                                   4.14.2 Market Restraints .................................................................................................... 41
                                                4.15 Global Electrosurgical Devices Market, Global, Company Shares (%), 2009 ................. 42
                                            5   Global Surgical Equipment Market: Country Analysis and Forecasts........................................ 45
                                                5.1    Surgical Equipment Market: Cross-Country Analysis...................................................... 45
                                                5.2    Revenue Forecasts, By Country, 2002 – 2016 ............................................................... 46
                                                   5.2.1    Surgical Equipment Market, US, Revenue ($m), 2002 – 2009 ................................ 46
                                                   5.2.2    Surgical Equipment Market, US, Revenue ($m), 2009 – 2016 ................................ 47
                                                   5.2.3    Surgical Equipment Market, Canada, Revenue ($m), 2002 – 2009......................... 48
                                                   5.2.4    Surgical Equipment Market, Canada, Revenue ($m), 2009 – 2016......................... 49
                                                   5.2.5    Surgical Equipment Market, UK, Revenue ($m), 2002 – 2009 ................................ 50
                                                   5.2.6    Surgical Equipment Market, UK, Revenue ($m), 2009 – 2016 ................................ 51
                                                   5.2.7    Surgical Equipment Market, Germany, Revenue ($m), 2002 – 2009 ...................... 52
                                                   5.2.8    Surgical Equipment Market, Germany, Revenue ($m), 2009 – 2016 ...................... 53

Surgical Equipment Market to 2016 - Emerging Economies to Provide                                                                            GBIME0009MR /Published JUN 2010
Future Growth Opportunities
                                                                                                                                                                                      Page 4
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                                                 5.2.9    Surgical Equipment Market, France, Revenue ($m), 2002 – 2009 .......................... 54
                                                 5.2.10 Surgical Equipment Market, France, Revenue ($m), 2009 – 2016 .......................... 55
                                                 5.2.11 Surgical Equipment Market, Italy, Revenue ($m), 2002 – 2009............................... 56
                                                 5.2.12 Surgical Equipment Market, Italy, Revenue ($m), 2009 – 2016............................... 57
                                                 5.2.13 Surgical Equipment Market, Spain, Revenue ($m), 2002 – 2009 ............................ 58
                                                 5.2.14 Surgical Equipment Market, Spain, Revenue ($m), 2009 – 2016 ............................ 59
                                                 5.2.15 Surgical Equipment Market, Japan, Revenue ($m), 2002 – 2009 ........................... 60
                                                 5.2.16 Surgical Equipment Market, Japan, Revenue ($m), 2009 – 2016 ........................... 61
                                                 5.2.17 Surgical Equipment Market, China, Revenue ($m), 2002 – 2009............................ 62
                                                 5.2.18 Surgical Equipment Market, China, Revenue ($m), 2009 – 2016............................ 63
                                                 5.2.19 Surgical Equipment Market, India, Revenue ($m), 2002 – 2009 ............................. 64
                                                 5.2.20 Surgical Equipment Market, India, Revenue ($m), 2009 – 2016 ............................. 65
                                                 5.2.21 Surgical Equipment Market, Australia, Revenue ($m), 2002 – 2009 ....................... 66
                                                 5.2.22 Surgical Equipment Market, Australia, Revenue ($m), 2009 – 2016 ....................... 67
                                                 5.2.23 Surgical Equipment Market, Brazil, Revenue ($m), 2002 – 2009 ............................ 68
                                                 5.2.24 Surgical Equipment Market, Brazil, Revenue ($m), 2009 – 2016 ............................ 69
                                            6 Global Surgical Equipment Market: Competitive Assessment ................................................... 70
                                              6.1    Surgical Equipment, Market Opportunities and Risk Evaluation ..................................... 70
                                              6.2    Ethicon ............................................................................................................................ 71
                                                 6.2.1    Business Overview .................................................................................................. 71
                                              6.3    Covidien .......................................................................................................................... 71
                                                 6.3.1    Business Overview .................................................................................................. 71
                                              6.4    B. Braun Melsungen ....................................................................................................... 71
                                                 6.4.1    Business Overview .................................................................................................. 72
                                              6.5    Integra LifeSciences ....................................................................................................... 72
                                                 6.5.1    Business Overview .................................................................................................. 72
                                              6.6    ERBE Elektromedizin...................................................................................................... 72
                                              6.7    CONMED Corporation .................................................................................................... 72
                                                 6.7.1    Business Overview .................................................................................................. 73
                                            7 Global Surgical Equipment Market: Product Pipeline Analysis .................................................. 74
                                              7.1    Surgical Sutures.............................................................................................................. 74
                                                 7.1.1    PolyMedix, Inc.: Antimicrobial suture....................................................................... 75
                                                 7.1.2    Ethicon, Inc.: PDS plus suture ................................................................................. 75
                                                 7.1.3    Suturox Ltd.: Spidrex ............................................................................................... 75
                                                 7.1.4    Sutura...................................................................................................................... 75
                                                 7.1.5    Tepha Inc.: TephaFLEX Absorbable Braided Sutures............................................. 76
                                              7.2    Hand Instruments............................................................................................................ 76
                                                 7.2.1    Minos Medical Inc.: Appendoectomy surgical tool ................................................... 77
                                                 7.2.2    FemSuite LLC: FemLap .......................................................................................... 77
                                                 7.2.3    Gray Surgical........................................................................................................... 77
                                                 7.2.4    Medigard Limited: IV Cannula/Catheter Introducer.................................................. 78
                                                 7.2.5    SafeStitch Medical Inc: Magnetic Retractors – NOTES........................................... 78
                                                 7.2.6    Foster-Miller, Inc...................................................................................................... 78
                                                 7.2.7    Ethicon Endo-Surgery, Inc.: NOTES Toolbox.......................................................... 78
                                                 7.2.8    Access Scientific, Inc.: PICC WAND ....................................................................... 79
                                                 7.2.9    Blue Belt Technologies, Inc.: Precision Freehand Sculptor ..................................... 79
                                                 7.2.10 SutureAid................................................................................................................. 79
                                                 7.2.11 USET Medical Ltd.: Vaginal Speculum with Ultrasound Facility .............................. 80
                                                 7.2.12 AllVascular Pty Ltd.: Venous Autograft Stent Loading Device................................. 80
                                              7.3    Electrosurgical Devices................................................................................................... 80
                                                 7.3.1    Bovie Medical Corporation: 1450RF Electrosurgical Generator .............................. 81
                                                 7.3.2    BioTex, Inc.: Cooled Laser Balloon ......................................................................... 81
                                                 7.3.3    AngioDynamics, Inc.: NanoKnife system................................................................. 81
                                                 7.3.4    Theraclion: Thyros................................................................................................... 82
                                            8 Global Surgical Equipment Market: Consolidation Landscape .................................................. 83

Surgical Equipment Market to 2016 - Emerging Economies to Provide                                                                          GBIME0009MR /Published JUN 2010
Future Growth Opportunities
                                                                                                                                                                                  Page 5
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                                              8.1    Deals by Volume, 2006 – 2009 ....................................................................................... 83
                                              8.2    Key Deals in 2009........................................................................................................... 92
                                                 8.2.1    Covidien Completes Acquisition of Power Medical Interventions ............................ 92
                                                 8.2.2    HealthTronics Completes Acquisition of Endocare.................................................. 92
                                            9 Appendix ................................................................................................................................... 93
                                              9.1    Definitions ....................................................................................................................... 93
                                                 9.1.1    Surgical Equipment ................................................................................................. 93
                                              9.2    Acronyms ........................................................................................................................ 93
                                              9.3    Research Methodology ................................................................................................... 94
                                                 9.3.1    Secondary Research ............................................................................................... 95
                                                 9.3.2    Primary Research.................................................................................................... 95
                                                 9.3.3    Models ..................................................................................................................... 95
                                                 9.3.4    Forecasts................................................................................................................. 96
                                                 9.3.5    Expert Panels .......................................................................................................... 96
                                              9.4    Contact Us ...................................................................................................................... 96
                                              9.5    Disclaimer ....................................................................................................................... 96




Surgical Equipment Market to 2016 - Emerging Economies to Provide                                                                          GBIME0009MR /Published JUN 2010
Future Growth Opportunities
                                                                                                                                                                                   Page 6
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                                            1.1     List of Tables
                                            Table 1:    Surgical Equipment Market, Global, Revenue ($ bn), 2002 – 2009 ............................... 10
                                            Table 2:    Surgical Equipment Market, Global, Revenue ($ bn), 2009 – 2016 ............................... 11
                                            Table 3:    Comparative Effectiveness Research Funding, 2009 .................................................... 14
                                            Table 4:    Healthcare Expenditure as Percentage of GDP, Emerging Economies, 2008 ............... 17
                                            Table 5:    65 and older population (m), Global, Percentage of 65 and older population, 2008 –
                                                        2015 ............................................................................................................................... 20
                                            Table 6:    Healthcare Expenditure as Percentage of GDP, Developed Countries, 2008................ 21
                                            Table 7:    Surgical Equipment Market, Global, Company Share (%), 2009 ................................... 23
                                            Table 8:    Surgical Sutures Market, Global, Revenue ($ bn), 2002 – 2009 .................................... 25
                                            Table 9:    Surgical Sutures Market, Global, Revenues ($ bn), 2009 – 2016 .................................. 26
                                            Table 10:   Surgical Sutures Market, Global, Company Share (%), 2009 ........................................ 30
                                            Table 11:   Ethicon, Key Surgical Sutures........................................................................................ 31
                                            Table 12:   Covidien, Key Surgical Sutures..................................................................................... 32
                                            Table 13:   B. Braun Melsungen AG, Key Surgical Sutures ............................................................. 33
                                            Table 14:   Hand Instruments Market, Global, Revenue ($ bn), 2002 – 2009 .................................. 34
                                            Table 15:   Hand Instruments Market, Global, Revenue ($ bn), 2009 – 2016 .................................. 35
                                            Table 16:   Hand Instruments Market, Global, Company Share (%), 2009 ...................................... 37
                                            Table 17:   Electrosurgical Devices Market, Global, Revenue ($m), 2002 – 2009 ........................... 38
                                            Table 18:   Electrosurgical Devices Market, Global, Revenue ($m), 2009 – 2016 ........................... 39
                                            Table 19:   Electrosurgical Devices Market, Global, Company Shares (%), 2009............................ 42
                                            Table 20:   Covidien, Key Electrosurgical Devices.......................................................................... 43
                                            Table 21:   ERBE Elektromedizin, Key Electrosurgical Devices....................................................... 43
                                            Table 22:   CONMED Corporation, Key Electrosurgical Devices ..................................................... 44
                                            Table 23:   Surgical Equipment Market, Cross – Country Analysis, Global, CAGR (%), 2002 – 2016
                                                        ....................................................................................................................................... 45
                                            Table 24:   Surgical Equipment Market, US, Revenue ($m), 2002 – 2009....................................... 46
                                            Table 25:   Surgical Equipment Market, US, Revenue ($m), 2009 – 2016....................................... 47
                                            Table 26:   Surgical Equipment Market, Canada, Revenue ($m), 2002 – 2009 ............................... 48
                                            Table 27:   Surgical Equipment Market, Canada, Revenue ($m), 2009 – 2016 ............................... 49
                                            Table 28:   Surgical Equipment Market, UK, Revenue ($m), 2002 – 2009....................................... 50
                                            Table 29:   Surgical Equipment Market, UK, Revenue ($m), 2009 – 2016....................................... 51
                                            Table 30:   Surgical Equipment Market, Germany, Revenue ($m), 2002 – 2009 ............................. 52
                                            Table 31:   Surgical Equipment Market, Germany, Revenue ($m), 2009 – 2016 ............................. 53
                                            Table 32:   Surgical Equipment Market, France, Revenue ($m), 2002 – 2009 ................................ 54
                                            Table 33:   Surgical Equipment Market, France, Revenue ($m), 2009 – 2016 ................................ 55
                                            Table 34:   Surgical Equipment Market, Italy, Revenue ($m), 2002 – 2009 ..................................... 56
                                            Table 35:   Surgical Equipment Market, Italy, Revenue ($m), 2009 – 2016 ..................................... 57
                                            Table 36:   Surgical Equipment Market, Spain, Revenue ($m), 2002 – 2009................................... 58
                                            Table 37:   Surgical Equipment Market, Spain, Revenue ($m), 2009 – 2016................................... 59
                                            Table 38:   Surgical Equipment Market, Japan, Revenue ($m), 2002 – 2009 .................................. 60
                                            Table 39:   Surgical Equipment Market, Japan, Revenue ($m), 2009 – 2016 .................................. 61
                                            Table 40:   Surgical Equipment Market, China, Revenue ($m), 2002 – 2009 .................................. 62
                                            Table 41:   Surgical Equipment Market, China, Revenue ($m), 2009 – 2016 .................................. 63
                                            Table 42:   Surgical Equipment Market, India, Revenue ($m), 2002 – 2009 .................................... 64
                                            Table 43:   Surgical Equipment Market, India, Revenue ($m), 2009 – 2016 .................................... 65
                                            Table 44:   Surgical Equipment Market, Australia, Revenue ($m), 2002 – 2009.............................. 66
                                            Table 45:   Surgical Equipment Market, Australia, Revenue ($m), 2009 – 2016.............................. 67
                                            Table 46:   Surgical Equipment Market, Brazil, Revenue ($m), 2002 – 2009................................... 68
                                            Table 47:   Surgical Equipment Market, Brazil, Revenue ($m), 2009 – 2016................................... 69
                                            Table 48:   Surgical Sutures, Pipeline Products ............................................................................... 74
                                            Table 49:   Hand Instruments, Pipeline Products ............................................................................. 76
                                            Table 50:   Electrosurgical Devices, Pipeline Products .................................................................... 80
                                            Table 51:   Surgical Equipment Market, Mergers & Acquisitions, by Volume, Global, 2006 – 2009 83
                                            Table 52:   Surgical Equipment Market, Mergers & Acquisitions, Global, 2006 ............................... 84
                                            Table 53:   Surgical Equipment Market, Mergers & Acquisitions, Global, 2007 ............................... 87
                                            Table 54:   Surgical Equipment Market, Mergers & Acquisitions, Global, 2008 ............................... 89
                                            Table 55:   Surgical Equipment Market, Mergers & Acquisitions, Global, 2009 ............................... 91




Surgical Equipment Market to 2016 - Emerging Economies to Provide                                                                            GBIME0009MR /Published JUN 2010
Future Growth Opportunities
                                                                                                                                                                                       Page 7
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                                            1.2     List of Figures
                                            Figure 1:    Surgical Equipment Market, Global, Revenue ($ bn), 2002 – 2009 ............................... 10
                                            Figure 2:    Surgical Equipment Market, Global, Revenue ($ bn), 2009 – 2016 ............................... 11
                                            Figure 3:    Electrosurgery Devices, Trends ..................................................................................... 12
                                            Figure
								
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