OPERATING ROOM EQUIPMENT: GLOBAL MARKETS

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1 OPERATING ROOM EQUIPMENT: GLOBAL MARKETS IAS095A June 2014 Bhavna Joshi Project Analyst ISBN: BCC Research 49 Walnut Park, Building 2 Wellesley, MA USA (toll-free within the USA), or (+1)

2 TABLE OF CONTENTS CHAPTER 1 INTRODUCTION 2 STUDY AND OBJECTIVE 2 STUDY BACKGROUND 2 SCOPE OF THE REPORT 3 INTENDED AUDIENCE 3 SOURCES OF INFORMATION AND METHODOLOGY 3 ANALYST'S CREDENTIALS 4 RELATED BCC RESEARCH REPORTS 4 BCC RESEARCH WEBSITE 5 DISCLAIMER 5 CHAPTER 2 EXECUTIVE SUMMARY 7 SUMMARY TABLE GLOBAL OPERATING ROOM MARKET BY REGION, THROUGH 2019 ($ SUMMARY FIGURE GLOBAL OPERATING ROOM MARKET BY REGION, ($ 7 7 CHAPTER 3 MARKET OVERVIEW 11 MARKET DEFINITION AND SCOPE 11 OR ENVIRONMENT 11 OPERATING ROOM EQUIPMENT 11 Life Support and Emergency Resuscitative Equipment 11 Patient Monitoring Equipment 12 Diagnostic Equipment 13 Other Operating Room Equipment 13 CONVENTIONAL OR VERSUS HYBRID OPERATING ROOM 13 CURRENT TRENDS: SURGICAL SUITES 13 MINIMAL REQUIREMENTS FOR A SMART OR 14 TRENDS DRIVING HYBRID OR INTEREST 15 CHALLENGES 16 BRIEF: FULLY INVASIVE SURGERIES TO MINIMALLY INVASIVE SURGERIES 17 ADVANTAGES OF NON-INVASIVE SURGERY 17 MEDICAL PROBLEMS THAT NON-INVASIVE SURGERY CAN TREAT 17 TECHNOLOGY INNOVATIONS AND TRENDS 19 TYPES OF SURGICAL PROCEDURES 21 TABLE 1 AVERAGE ANNUAL NUMBER OF INPATIENT SURGERIES IN THE U.S. 22 GLOBAL BURDEN OF DISEASES 22 Injuries 23 Obstetrics 23 REGULATIONS 24 SOURCES OF SSIS 24 PRODUCT CONTROL 25 Vendor Establishment Control 27 POSTMARKET SURVEILLANCE/VIGILANCE 27 QUALITY SYSTEM REQUIREMENTS 28 TABLE 2 LIFE SPAN OF A MEDICAL DEVICE 29

3 Conception and Development 29 Quality Systems in Manufacturing 30 Packaging and Labeling 30 Advertising 30 Sale 30 Use 31 Disposal 31 VALUE CHAIN ANALYSIS 31 FIGURE 1 ROLES OF STAKEHOLDERS IN THE OR MARKET 32 FIGURE 2 ROLES OF STAKEHOLDERS IN THE OR MARKET 34 CASE STUDY: STRATEGIES FOR GREENER HOSPITAL OPERATING ROOMS 35 SURGICAL IMAGING DISPLAY MARKET PROMISING GREAT FUTURE 36 FIGURE 3 CURRENT AND FUTURE OR MARKETS, 2011-APRIL M&A'S POPULAR AMONG SMALL COMPANIES AS WELL 37 FIGURE 4 RECENT DEVELOPMENTS BY COMPANIES, 2011-APRIL 2014 (%) 37 CONSISTENTLY INCREASING OR PATENTS FOCUSING ON DISPLAY SYSTEMS 38 FIGURE 5 NUMBER OF OR PATENTS BY YEAR 38 FIGURE 6 NUMBER OF OR PATENTS BY REGION 2007 TO APRIL 2014 (%) 39 FIGURE 7 NUMBER OF OR PATENTS BY TECHNOLOGY 2007 TO APRIL 2014 (%) 40 MARKET DYNAMICS 41 MARKET DRIVERS 41 Increasing Number of ASCs (Ambulatory Surgical Centers) 41 Increasing Demand for Hybrid ORs 41 Product Innovations Driven by Advances in Technology 41 MARKET RESTRAINTS 42 High Cost of Operating Room Equipment 42 MARKET OPPORTUNITIES 42 EMERGING ECONOMIES IN ASIA-PACIFIC AND LATIN AMERICA 42 Technology is the Key to Success 43 Cost of Equipment Influences Sale 43 RECOMMENDATION 43 CHAPTER 4 OPERATING ROOM MARKET BY PRODUCT TYPE 46 TABLE 3 GLOBAL OPERATING ROOM MARKET, ($ 46 TABLE 4 GLOBAL OPERATING ROOM MARKET BY TYPE OF EQUIPMENT, ($ OPERATING TABLES 47 TABLE 5 GLOBAL OPERATING TABLE MARKET BY TYPES, THROUGH 2019 ($ TABLE 6 GLOBAL OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ GENERAL OPERATING TABLE 49 TABLE 7 GLOBAL GENERAL OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ SPECIALTY OPERATING TABLES 49 TABLE 8 GLOBAL SPECIALTY OPERATING TABLE MARKET BY TYPES, THROUGH 2019 ($ TABLE 9 GLOBAL SPECIALTY OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($

4 Electromatic Operation Table 50 TABLE 10 GLOBAL ELECTROMATIC OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ Orthopedic Tables 51 TABLE 11 GLOBAL ORTHOPEDIC TABLE MARKET BY REGION, THROUGH 2019 ($ Hydraulic Surgical Operating Table 52 TABLE 12 GLOBAL HYDRAULIC SURGICAL OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ Mobile Operating Tables 53 TABLE 13 GLOBAL MOBILE OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ INSUFFLATION DEVICES 53 TABLE 14 GLOBAL INSUFFLATION DEVICES MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 15 GLOBAL INSUFFLATION DEVICES MARKET BY REGION, THROUGH 2019 ($ VERESS NEEDLES 54 TABLE 16 GLOBAL VERESS NEEDLES MARKET BY REGION, THROUGH 2019 ($ INSUFFULATOR SYSTEMS 55 TABLE 17 GLOBAL INSUFFLATOR SYSTEM MARKET BY REGION, THROUGH 2019 ($ INSUFFULATOR TUBING 55 TABLE 18 GLOBAL INSUFFLATOR TUBING MARKET BY REGION, THROUGH 2019 ($ SURGICAL MICROSCOPES 56 TABLE 19 GLOBAL SURGICAL MICROSCOPE MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 20 GLOBAL SURGICAL MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ OPHTHALMOLOGY/OPTOMETRY MICROSCOPE 57 TABLE 21 GLOBAL OPHTHALMOLOGY/OPTOMETRY MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ NEUROSURGERY MICROSCOPE 58 TABLE 22 GLOBAL NEUROSURGERY MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ ENT MICROSCOPE MARKET 59 TABLE 23 GLOBAL ENT MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ SPINE MICROSCOPE MARKET 59 TABLE 24 GLOBAL SPINE MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ PLASTIC RECONSTRUCTIVE SURGERY MICROSCOPES 60 TABLE 25 GLOBAL PLASTIC RECONSTRUCTIVE SURGERY MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ OPERATING ROOM LIGHTS 60 TABLE 26 GLOBAL OPERATING ROOM LIGHTS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 27 GLOBAL OPERATING ROOM LIGHTS MARKET BY REGION, THROUGH 2019 ($

5 OR LIGHTING BY TYPES 62 Xenon 62 TABLE 28 GLOBAL OPERATING ROOM XENON LIGHTS MARKET BY REGION, THROUGH 2019 ($ LED 62 TABLE 29 GLOBAL OPERATING ROOM LED LIGHTS MARKET BY REGION, THROUGH 2019 ($ Halogen 63 TABLE 30 GLOBAL OPERATING ROOM HALOGEN LIGHTS MARKET BY REGION, THROUGH 2019 ($ EQUIPMENT MANAGEMENT SYSTEM 64 TABLE 31 GLOBAL EQUIPMENT MANAGEMENT SYSTEM MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 32 GLOBAL EQUIPMENT MANAGEMENT SYSTEM MARKET BY REGION, THROUGH 2019 ($ BOOM SYSTEMS 64 TABLE 33 GLOBAL BOOM SYSTEM MARKET BY REGION, THROUGH 2019 ($ COMBINATION MOUNTING SOLUTION 65 TABLE 34 GLOBAL COMBINATION MOUNTING SOLUTION MARKET BY REGION, THROUGH 2019 ($ OTHER EQUIPMENT MANAGEMENT SYSTEMS 66 TABLE 35 GLOBAL OTHER EQUIPMENT MANAGEMENT SYSTEM MARKET BY REGION, THROUGH 2019 ($ DIGITAL IMAGE CAPTURE AND RECORDING DEVICES 67 TABLE 36 GLOBAL DIGITAL IMAGE CAPTURE AND RECORDING SYSTEM MARKET BY REGION, THROUGH 2019 ($ MEDICAL PRINTERS 68 TABLE 37 GLOBAL MEDICAL PRINTERS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 38 GLOBAL MEDICAL PRINTERS MARKET BY REGION, THROUGH 2019 ($ MEDICAL GRADE PHOTO PRINTERS 69 TABLE 39 GLOBAL MEDICAL GRADE PHOTO PRINTERS MARKET BY REGION, THROUGH 2019 ($ NON-MEDICAL GRADE INKJET PRINTERS 69 TABLE 40 GLOBAL NON-MEDICAL GRADE PHOTO PRINTERS MARKET BY REGION, THROUGH 2019 ($ SURGICAL IMAGING DISPLAYS 70 TABLE 41 GLOBAL SURGICAL IMAGING DISPLAYS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 42 GLOBAL SURGICAL IMAGING DISPLAYS MARKET BY REGION, THROUGH 2019 ($ 3D ULTRASOUND 71 TABLE 43 GLOBAL 3D ULTRASOUND MARKET BY REGION, THROUGH 2019 ($ INFRARED IMAGING SYSTEMS 71 TABLE 44 GLOBAL INFRARED IMAGING SYSTEMS MARKET BY REGION, THROUGH 2019 ($ C-ARM X-RAY 72 TABLE 45 GLOBAL C-ARM X-RAY MARKET BY REGION, THROUGH 2019 ($

6 SURGICAL NAVIGATION SYSTEM 73 TABLE 46 GLOBAL SURGICAL NAVIGATION SYSTEM MARKET BY REGION, THROUGH 2019 ($ PET 74 TABLE 47 GLOBAL PET MARKET BY REGION, THROUGH 2019 ($ 74 3D INTERACTIVE DISPLAY SYSTEMS 74 TABLE 48 GLOBAL 3D INTERACTIVE DISPLAY SYSTEMS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 49 GLOBAL 3D INTERACTIVE DISPLAY SYSTEMS MARKET BY REGION, THROUGH 2019 ($ 3D MRI Scanners 75 TABLE 50 GLOBAL 3D MRI SCANNER SYSTEMS MARKET BY REGION, THROUGH 2019 ($ 3D CT Scans 76 TABLE 51 GLOBAL 3D CT SCAN MARKET BY REGION, THROUGH 2019 ($ 76 COMPUTER ASSISTED AND ROBOTIC SURGERY 77 TABLE 52 GLOBAL COMPUTER ASSISTED AND ROBOTIC SURGERY MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 53 GLOBAL COMPUTER ASSISTED AND ROBOTIC SURGERY MARKET BY REGION, THROUGH 2019 ($ 3D VISION 78 TABLE 54 GLOBAL 3D VISION MARKET BY REGION, THROUGH 2019 ($ 78 FORCEPS 79 TABLE 55 GLOBAL FORCEPS MARKET BY REGION, THROUGH 2019 ($ 79 NEEDLE DRIVERS 79 TABLE 56 GLOBAL NEEDLE DRIVERS MARKET BY REGION, THROUGH 2019 ($ MOTION CONTROL 80 TABLE 57 GLOBAL MOTION CONTROL MARKET BY REGION, THROUGH 2019 ($ RETRACTORS 80 TABLE 58 GLOBAL RETRACTORS MARKET BY REGION, THROUGH 2019 ($ 81 CAMERAS 81 TABLE 59 GLOBAL CAMERAS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 60 GLOBAL CAMERAS MARKET BY REGION, THROUGH 2019 ($ 81 High Definition (HD) 82 TABLE 61 GLOBAL HD CAMERAS MARKET BY REGION, THROUGH 2019 ($ 82 Standard Digital Cameras (SD) 82 TABLE 62 GLOBAL SD CAMERAS MARKET BY REGION, THROUGH 2019 ($ 82 OTHER OR EQUIPMENT MARKET 83 TABLE 63 GLOBAL OTHER OR EQUIPMENT MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 64 GLOBAL OTHER OR EQUIPMENT MARKET BY REGION, THROUGH 2019 ($ SWITCH POINT CONTROL SYSTEM 83 TABLE 65 GLOBAL SWITCH POINT CONTROL SYSTEM MARKET BY REGION, THROUGH 2019 ($ DOCUMENTATION STATIONS

7 TABLE 66 GLOBAL DOCUMENTATION STATION MARKET BY REGION, THROUGH 2019 ($ CABLE KITS 84 TABLE 67 GLOBAL CABLE KITS MARKET BY REGION, THROUGH 2019 ($ CHAPTER 5 OR DATA MANAGEMENT SYSTEMS AND COMMUNICATIONS TOOLS 87 TABLE 68 GLOBAL OR DATA MANAGEMENT SYSTEMS AND COMMUNICATIONS TOOLS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 69 GLOBAL OR DATA MANAGEMENT SYSTEMS AND COMMUNICATIONS TOOLS MARKET BY REGION, THROUGH 2019 ($ OPERATING ROOM INTEGRATION SYSTEMS AND PACS 90 IMPORTANCE OF OR INTEGRATION SYSTEMS 92 KEY BENEFITS OF OR INTEGRATION SYSTEMS 92 TABLE 70 GLOBAL OR INTEGRATION SYSTEMS AND PACS MARKET BY REGION, THROUGH 2019 ($ OPERATING ROOM MANAGEMENT SYSTEMS 93 FOCUS ON THE PROCESS 94 PREOPERATIVE CLINICS 94 FACILITIES 94 PERSONNEL 95 STAKEHOLDERS AND OR MANAGEMENT SYSTEMS 95 TABLE 71 GLOBAL OR MANAGEMENT SYSTEMS MARKET BY REGION, THROUGH 2019 ($ ANESTHESIA INFORMATION MANAGEMENT SYSTEMS 95 TABLE 72 GLOBAL ANESTHESIA INFORMATION SYSTEMS MARKET BY REGION, THROUGH 2019 ($ EMERGENCY MEDICAL SERVICES 98 TABLE 73 GLOBAL EMERGENCY MEDICAL SERVICES MARKET BY REGION, THROUGH 2019 ($ AMBULANCE BASED TELEMEDICINE/TELETRAUMA CARE - VITAL SIGN MONITORING VIA 3G/WI-FI-COMMUNICATION PLATFORM AMBULANCE-BASED TELEMEDICINE SAVING LIVES IN REAL TIME 101 APPLICATION ARCHITECTURE 102 FUNCTIONS 102 Remote Patient Monitoring 102 Real-time Medical Practitioner "Tele-presence" 103 Mobile EMS Services and Teletrauma Care 103 GPS Tracking 103 Electronic Patient Care Reporting (e-pcr) 103 Specialist Referral Services 103 TABLE 74 GLOBAL AMBULANCE-BASED TELEMEDICINE/TELE TRAUMA CARE - VITAL SIGN MONITORING VIA 3G/WI-FI-COMMUNICATION PLATFORM MARKET BY REGION, THROUGH 2019 ($ OTHERS: SURGICAL INFORMATION SYSTEMS 104 TABLE 75 GLOBAL OTHER SURGICAL INFORMATION SYSTEMS MARKET BY REGION, THROUGH 2019 ($ CHAPTER 6 OR MARKET BY END USERS 107 TABLE 76 GLOBAL OR END USERS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ 107

8 HOSPITALS 108 FIGURE 8 ADOPTION OF DIAGNOSTIC IMAGING TECHNOLOGIES IN CANADA, 2003 AND 2008 ($ TABLE 77 GLOBAL END-USER MARKET: HOSPITALS BY REGION, ($ AMBULATORY SURGICAL CENTERS 111 FIGURE 9 TYPES OF SURGERIES PERFORMED IN ASCS IN THE U.S. (%) 112 TABLE 78 GLOBAL END-USER MARKET: AMBULATORY SURGICAL CENTERS BY REGION, ($ CLINICS 114 TABLE 79 GLOBAL END-USER MARKET: CLINICS BY REGION, THROUGH 2019 ($ MEDICAL RESEARCH INSTITUTES 115 TABLE 80 GLOBAL END-USER MARKET: MEDICAL RESEARCH INSTITUTE BY REGION, THROUGH 2019 ($ CHAPTER 7 COMPETITIVE LANDSCAPE 118 NEW PRODUCT DEVELOPMENT 118 FIGURE 10 NEW PRODUCT DEVELOPMENT BY COMPANY, (%) 118 TABLE 81 NEW PRODUCTS BY COMPANY, MERGERS AND ACQUISITIONS (M&A) 125 FIGURE 11 MERGERS AND ACQUISITIONS BY COMPANY, (%) 125 TABLE 82 MERGERS AND ACQUISITIONS BY COMPANY, PRODUCT CERTIFICATIONS AND APPROVALS 129 FIGURE 12 PRODUCT CERTIFICATIONS AND APPROVALS BY COMPANY, (%) TABLE 83 CERTIFICATION AND PRODUCT APPROVALS BY COMPANY, JOINT VENTURES (JV) 131 FIGURE 13 JOINT VENTURES BY COMPANY, (%) 131 TABLE 84 JOINT VENTURES BY COMPANY, AGREEMENT AND PARTNERSHIPS 133 TABLE 85 AGREEMENTS AND PARTNERSHIPS BY COMPANY, OTHER STRATEGIES 135 TABLE 86 OTHER STRATEGIES BY COMPANY, CHAPTER 8 GEOGRAPHIC ANALYSIS 138 NORTH AMERICA 139 FIGURE 14 PATIENTS USING SURGICAL FACILITIES BY AGE GROUP IN THE U.S. (%) 139 TABLE 87 NORTH AMERICA OR EQUIPMENT MARKET BY TYPE, THROUGH 2019 ($ TABLE 88 NORTH AMERICA DATA MANAGEMENT AND COMMUNICATION TOOLS MARKET BY TYPES, THROUGH 2019 ($ EUROPE 142 TABLE 89 POPULATION DEMOGRAPHICS IN EUROPEAN COUNTRIES, 2010 AND 2060 TABLE 90 NUMBER OF OPERATING ROOMS IN EUROPE, FIGURE 15 NUMBER OF OPERATING ROOMS PER 100,000 POPULATION IN EUROPE, 2010 TABLE 91 EUROPEAN OR EQUIPMENT MARKET BY TYPES, THROUGH 2019 ($

9 TABLE 92 EUROPEAN OR DATA MANAGEMENT AND COMMUNICATION TOOLS MARKET BY TYPE, THROUGH 2019 ($ ASIA-PACIFIC 146 TABLE 93 NUMBER OF OPERATING ROOMS IN ASIA PACIFIC 147 FIGURE 16 NUMBER OF OPERATION ROOMS PER 100,000 POPULATION IN ASIA-PACIFIC TABLE 94 ESTIMATED POPULATION OF OVER 65 YEARS, 2013 AND INDIA 149 JAPAN 149 TABLE 95 ASIAN OR EQUIPMENT MARKET BY TYPE, THROUGH 2019 ($ 149 TABLE 96 ASIAN OR DATA MANAGEMENT AND COMMUNICATION TOOLS MARKET BY TYPE, THROUGH 2019 ($ REST OF THE WORLD 150 TABLE 97 OPERATING ROOMS IN ROW 151 FIGURE 17 ESTIMATED NUMBER OF ORS PER 100,000 PEOPLE IN LATIN AMERICA AND THE CARIBBEAN TABLE 98 ROW OR EQUIPMENT MARKET BY TYPE, THROUGH 2019 ($ 152 TABLE 99 ROW OR DATA MANAGEMENT AND COMMUNICATION TOOLS MARKET BY TYPE, THROUGH 2019 ($ CHAPTER 9 PATENT ANALYSIS 155 U.S. PATENT ANALYSIS 155 FIGURE 18 U.S. PATENTS BY TECHNOLOGY, (%) 155 FIGURE 19 U.S. PATENTS BY COMPANY, (%) 156 EUROPEAN PATENT ANALYSIS 157 FIGURE 20 EUROPEAN PATENTS BY TECHNOLOGY, (%) 157 FIGURE 21 EUROPEAN PATENTS BY COMPANIES, (%) 157 JAPAN PATENT ANALYSIS 158 FIGURE 22 JAPAN PATENTS BY TECHNOLOGY, (%) 158 FIGURE 23 JAPAN PATENTS BY COMPANY, (%) 159 CHAPTER 10 COMPANY PROFILES 162 BARCO 162 TABLE 100 BARCO PRODUCT PORTFOLIO 162 TABLE 101 BARCO. RECENT DEVELOPMENTS (2011 TO APRIL 2014) 162 BERCHTOLD CORP. 164 TABLE 102 BERCHTOLD PRODUCT PORTFOLIO 164 TABLE 103 BERCHTOLD RECENT DEVELOPMENTS ( ) 165 CONMED CORP. 165 TABLE 104 CONMED PRODUCT PORTFOLIO 166 TABLE 105 CONMED RECENT DEVELOPMENTS ( ) 166 ESCHMANN EQUIPMENT 167 TABLE 106 ESCHMANN EQUIPMENT PRODUCT PORTFOLIO 167 TABLE 107 ESCHMANN EQUIPMENT RECENT DEVELOPMENTS ( ) 168 GE HEALTHCARE 168 TABLE 108 GE HEALTHCARE PRODUCT PORTFOLIO 168 TABLE 109 GE HEALTHCARE RECENT DEVELOPMENTS ( ) 169 GETINGE GROUP 171

10 TABLE 110 GETINGE GROUP PRODUCT PORTFOLIO 171 TABLE 111 GETINGE GROUP RECENT DEVELOPMENTS ( ) 172 KARL STORZ GMBH & CO. KG 172 TABLE 112 KARL STORZ PRODUCT PORTFOLIO 173 TABLE 113 KARL STORZ RECENT DEVELOPMENTS (2011 TO APRIL 2014) 173 LEICA MICROSYSTEMS 174 TABLE 114 LEICA MICROSYSTEMS PRODUCT PORTFOLIO 175 TABLE 115 LEICA MICROSYSTEMS RECENT DEVELOPMENTS ( ) 175 MIZUHO OSI 176 TABLE 116 MIZUHO OSI PRODUCT PORTFOLIO 177 TABLE 117 MIZUHO OSI RECENT DEVELOPMENTS ( ) 177 PHILIPS HEALTHCARE 178 TABLE 118 PHILIPS HEALTHCARE PRODUCT PORTFOLIO 178 TABLE 119 PHILIPS HEALTHCARE RECENT DEVELOPMENTS ( ) 179 SIEMENS HEALTHCARE 180 TABLE 120 SIEMENS HEALTHCARE PRODUCT PORTFOLIO 180 TABLE 121 SIEMENS HEALTHCARE RECENT DEVELOPMENTS ( ) 181 SKYTRON LLC 182 TABLE 122 SKYTRON PRODUCT PORTFOLIO 183 TABLE 123 SKYTRON RECENT DEVELOPMENTS ( ) 183 SMITH & NEPHEW 184 TABLE 124 SMITH & NEPHEW PRODUCT PORTFOLIO 184 TABLE 125 SMITH & NEPHEW RECENT DEVELOPMENTS ( ) 184 SONY MEDICAL 185 TABLE 126 SONY MEDICAL PRODUCT PORTFOLIO 186 TABLE 127 SONY MEDICAL RECENT DEVELOPMENTS ( ) 186 STERIS CORP. 186 TABLE 128 STERIS PRODUCT PORTFOLIO 187 TABLE 129 STERIS RECENT DEVELOPMENTS ( ) 187 STRYKER CORP. 188 TABLE 130 STRYKER PRODUCT PORTFOLIO 188 TABLE 131 STRYKER RECENT DEVELOPMENTS ( ) 188 OLYMPUS CORP. 190 TABLE 132 OLYMPUS PRODUCT PORTFOLIO 190 TABLE 133 OLYMPUS RECENT DEVELOPMENTS ( ) 191 TOSHIBA MEDICAL SYSTEMS CORP. 191 TABLE 134 TOSHIBA MEDICAL SYSTEMS PRODUCT PORTFOLIO 192 TABLE 135 TOSHIBA MEDICAL SYSTEMS RECENT DEVELOPMENTS ( ) 192 TRUMPF GMBH & CO. KG 192 TABLE 136 TRUMPF PRODUCT PORTFOLIO 193 TABLE 137 TRUMPF RECENT DEVELOPMENTS ( ) 193 NDS SURGICAL IMAGING 194 TABLE 138 NDS SURGICAL IMAGING PRODUCT PORTFOLIO 194 TABLE 139 NDS SURGICAL IMAGING RECENT DEVELOPMENTS ( ) 195 CHAPTER 11 APPENDIX 198 TABLE 140 U.S. PATENT LIST,

11 TABLE 141 EUROPEAN PATENT LIST, TABLE 142 JAPAN PATENT LIST,

12 LIST OF TABLES TABLE HEADING SUMMARY TABLE GLOBAL OPERATING ROOM MARKET BY REGION, THROUGH 2019 ($ TABLE 1 AVERAGE ANNUAL NUMBER OF INPATIENT SURGERIES IN THE U.S. 22 TABLE 2 LIFE SPAN OF A MEDICAL DEVICE 29 TABLE 3 GLOBAL OPERATING ROOM MARKET, ($ 46 TABLE 4 GLOBAL OPERATING ROOM MARKET BY TYPE OF EQUIPMENT, ($ TABLE 5 GLOBAL OPERATING TABLE MARKET BY TYPES, THROUGH 2019 ($ TABLE 6 GLOBAL OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ TABLE 7 GLOBAL GENERAL OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ TABLE 8 GLOBAL SPECIALTY OPERATING TABLE MARKET BY TYPES, THROUGH 2019 ($ TABLE 9 GLOBAL SPECIALTY OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ TABLE 10 GLOBAL ELECTROMATIC OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ TABLE 11 GLOBAL ORTHOPEDIC TABLE MARKET BY REGION, THROUGH 2019 ($ TABLE 12 GLOBAL HYDRAULIC SURGICAL OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ TABLE 13 GLOBAL MOBILE OPERATING TABLE MARKET BY REGION, THROUGH 2019 ($ TABLE 14 GLOBAL INSUFFLATION DEVICES MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 15 GLOBAL INSUFFLATION DEVICES MARKET BY REGION, THROUGH 2019 ($ TABLE 16 GLOBAL VERESS NEEDLES MARKET BY REGION, THROUGH 2019 ($ TABLE 17 GLOBAL INSUFFLATOR SYSTEM MARKET BY REGION, THROUGH 2019 ($ TABLE 18 GLOBAL INSUFFLATOR TUBING MARKET BY REGION, THROUGH 2019 ($ TABLE 19 GLOBAL SURGICAL MICROSCOPE MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 20 GLOBAL SURGICAL MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ TABLE 21 GLOBAL OPHTHALMOLOGY/OPTOMETRY MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ TABLE 22 GLOBAL NEUROSURGERY MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ TABLE 23 GLOBAL ENT MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ TABLE 24 GLOBAL SPINE MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ TABLE 25 GLOBAL PLASTIC RECONSTRUCTIVE SURGERY MICROSCOPE MARKET BY REGION, THROUGH 2019 ($ TABLE 26 GLOBAL OPERATING ROOM LIGHTS MARKET BY PRODUCT TYPE, THROUGH 2019 ($

13 TABLE HEADING TABLE 27 GLOBAL OPERATING ROOM LIGHTS MARKET BY REGION, THROUGH 2019 ($ TABLE 28 GLOBAL OPERATING ROOM XENON LIGHTS MARKET BY REGION, THROUGH 2019 ($ TABLE 29 GLOBAL OPERATING ROOM LED LIGHTS MARKET BY REGION, THROUGH 2019 ($ TABLE 30 GLOBAL OPERATING ROOM HALOGEN LIGHTS MARKET BY REGION, THROUGH 2019 ($ TABLE 31 GLOBAL EQUIPMENT MANAGEMENT SYSTEM MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 32 GLOBAL EQUIPMENT MANAGEMENT SYSTEM MARKET BY REGION, THROUGH 2019 ($ TABLE 33 GLOBAL BOOM SYSTEM MARKET BY REGION, THROUGH 2019 ($ 65 TABLE 34 GLOBAL COMBINATION MOUNTING SOLUTION MARKET BY REGION, THROUGH 2019 ($ TABLE 35 GLOBAL OTHER EQUIPMENT MANAGEMENT SYSTEM MARKET BY REGION, THROUGH 2019 ($ TABLE 36 GLOBAL DIGITAL IMAGE CAPTURE AND RECORDING SYSTEM MARKET BY REGION, THROUGH 2019 ($ TABLE 37 GLOBAL MEDICAL PRINTERS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 38 GLOBAL MEDICAL PRINTERS MARKET BY REGION, THROUGH 2019 ($ TABLE 39 GLOBAL MEDICAL GRADE PHOTO PRINTERS MARKET BY REGION, THROUGH 2019 ($ TABLE 40 GLOBAL NON-MEDICAL GRADE PHOTO PRINTERS MARKET BY REGION, THROUGH 2019 ($ TABLE 41 GLOBAL SURGICAL IMAGING DISPLAYS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 42 GLOBAL SURGICAL IMAGING DISPLAYS MARKET BY REGION, THROUGH 2019 ($ TABLE 43 GLOBAL 3D ULTRASOUND MARKET BY REGION, THROUGH 2019 ($ TABLE 44 GLOBAL INFRARED IMAGING SYSTEMS MARKET BY REGION, THROUGH 2019 ($ TABLE 45 GLOBAL C-ARM X-RAY MARKET BY REGION, THROUGH 2019 ($ 73 TABLE 46 GLOBAL SURGICAL NAVIGATION SYSTEM MARKET BY REGION, THROUGH 2019 ($ TABLE 47 GLOBAL PET MARKET BY REGION, THROUGH 2019 ($ 74 TABLE 48 GLOBAL 3D INTERACTIVE DISPLAY SYSTEMS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 49 GLOBAL 3D INTERACTIVE DISPLAY SYSTEMS MARKET BY REGION, THROUGH 2019 ($ TABLE 50 GLOBAL 3D MRI SCANNER SYSTEMS MARKET BY REGION, THROUGH 2019 ($ TABLE 51 GLOBAL 3D CT SCAN MARKET BY REGION, THROUGH 2019 ($ 76 TABLE 52 GLOBAL COMPUTER ASSISTED AND ROBOTIC SURGERY MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 53 GLOBAL COMPUTER ASSISTED AND ROBOTIC SURGERY MARKET BY REGION, THROUGH 2019 ($ TABLE 54 GLOBAL 3D VISION MARKET BY REGION, THROUGH 2019 ($ 78 TABLE 55 GLOBAL FORCEPS MARKET BY REGION, THROUGH 2019 ($

14 TABLE HEADING TABLE 56 GLOBAL NEEDLE DRIVERS MARKET BY REGION, THROUGH 2019 ($ TABLE 57 GLOBAL MOTION CONTROL MARKET BY REGION, THROUGH 2019 ($ TABLE 58 GLOBAL RETRACTORS MARKET BY REGION, THROUGH 2019 ($ 81 TABLE 59 GLOBAL CAMERAS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 60 GLOBAL CAMERAS MARKET BY REGION, THROUGH 2019 ($ 81 TABLE 61 GLOBAL HD CAMERAS MARKET BY REGION, THROUGH 2019 ($ 82 TABLE 62 GLOBAL SD CAMERAS MARKET BY REGION, THROUGH 2019 ($ 82 TABLE 63 GLOBAL OTHER OR EQUIPMENT MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 64 GLOBAL OTHER OR EQUIPMENT MARKET BY REGION, THROUGH 2019 ($ TABLE 65 GLOBAL SWITCH POINT CONTROL SYSTEM MARKET BY REGION, THROUGH 2019 ($ TABLE 66 GLOBAL DOCUMENTATION STATION MARKET BY REGION, THROUGH 2019 ($ TABLE 67 GLOBAL CABLE KITS MARKET BY REGION, THROUGH 2019 ($ 85 TABLE 68 GLOBAL OR DATA MANAGEMENT SYSTEMS AND COMMUNICATIONS TOOLS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 69 GLOBAL OR DATA MANAGEMENT SYSTEMS AND COMMUNICATIONS TOOLS MARKET BY REGION, THROUGH 2019 ($ TABLE 70 GLOBAL OR INTEGRATION SYSTEMS AND PACS MARKET BY REGION, THROUGH 2019 ($ TABLE 71 GLOBAL OR MANAGEMENT SYSTEMS MARKET BY REGION, THROUGH 2019 ($ TABLE 72 GLOBAL ANESTHESIA INFORMATION SYSTEMS MARKET BY REGION, THROUGH 2019 ($ TABLE 73 GLOBAL EMERGENCY MEDICAL SERVICES MARKET BY REGION, THROUGH 2019 ($ TABLE 74 GLOBAL AMBULANCE-BASED TELEMEDICINE/TELE TRAUMA CARE - VITAL SIGN MONITORING VIA 3G/WI-FI-COMMUNICATION PLATFORM MARKET BY REGION, THROUGH 2019 ($ TABLE 75 GLOBAL OTHER SURGICAL INFORMATION SYSTEMS MARKET BY REGION, THROUGH 2019 ($ TABLE 76 GLOBAL OR END USERS MARKET BY PRODUCT TYPE, THROUGH 2019 ($ TABLE 77 GLOBAL END-USER MARKET: HOSPITALS BY REGION, ($ TABLE 78 GLOBAL END-USER MARKET: AMBULATORY SURGICAL CENTERS BY REGION, ($ TABLE 79 GLOBAL END-USER MARKET: CLINICS BY REGION, THROUGH 2019 ($ TABLE 80 GLOBAL END-USER MARKET: MEDICAL RESEARCH INSTITUTE BY REGION, THROUGH 2019 ($ TABLE 81 NEW PRODUCTS BY COMPANY, TABLE 82 MERGERS AND ACQUISITIONS BY COMPANY, TABLE 83 CERTIFICATION AND PRODUCT APPROVALS BY COMPANY, TABLE 84 JOINT VENTURES BY COMPANY, TABLE 85 AGREEMENTS AND PARTNERSHIPS BY COMPANY,

15 TABLE HEADING TABLE 86 OTHER STRATEGIES BY COMPANY, TABLE 87 NORTH AMERICA OR EQUIPMENT MARKET BY TYPE, THROUGH 2019 ($ TABLE 88 NORTH AMERICA DATA MANAGEMENT AND COMMUNICATION TOOLS MARKET BY TYPES, THROUGH 2019 ($ TABLE 89 POPULATION DEMOGRAPHICS IN EUROPEAN COUNTRIES, 2010 AND TABLE 90 NUMBER OF OPERATING ROOMS IN EUROPE, TABLE 91 EUROPEAN OR EQUIPMENT MARKET BY TYPES, THROUGH 2019 ($ TABLE 92 EUROPEAN OR DATA MANAGEMENT AND COMMUNICATION TOOLS MARKET BY TYPE, THROUGH 2019 ($ TABLE 93 NUMBER OF OPERATING ROOMS IN ASIA PACIFIC 147 TABLE 94 ESTIMATED POPULATION OF OVER 65 YEARS, 2013 AND TABLE 95 ASIAN OR EQUIPMENT MARKET BY TYPE, THROUGH 2019 ($ 149 TABLE 96 ASIAN OR DATA MANAGEMENT AND COMMUNICATION TOOLS MARKET BY TYPE, THROUGH 2019 ($ TABLE 97 OPERATING ROOMS IN ROW 151 TABLE 98 ROW OR EQUIPMENT MARKET BY TYPE, THROUGH 2019 ($ 152 TABLE 99 ROW OR DATA MANAGEMENT AND COMMUNICATION TOOLS MARKET BY TYPE, THROUGH 2019 ($ TABLE 100 BARCO PRODUCT PORTFOLIO 162 TABLE 101 BARCO. RECENT DEVELOPMENTS (2011 TO APRIL 2014) 162 TABLE 102 BERCHTOLD PRODUCT PORTFOLIO 164 TABLE 103 BERCHTOLD RECENT DEVELOPMENTS ( ) 165 TABLE 104 CONMED PRODUCT PORTFOLIO 166 TABLE 105 CONMED RECENT DEVELOPMENTS ( ) 166 TABLE 106 ESCHMANN EQUIPMENT PRODUCT PORTFOLIO 167 TABLE 107 ESCHMANN EQUIPMENT RECENT DEVELOPMENTS ( ) 168 TABLE 108 GE HEALTHCARE PRODUCT PORTFOLIO 168 TABLE 109 GE HEALTHCARE RECENT DEVELOPMENTS ( ) 169 TABLE 110 GETINGE GROUP PRODUCT PORTFOLIO 171 TABLE 111 GETINGE GROUP RECENT DEVELOPMENTS ( ) 172 TABLE 112 KARL STORZ PRODUCT PORTFOLIO 173 TABLE 113 KARL STORZ RECENT DEVELOPMENTS (2011 TO APRIL 2014) 173 TABLE 114 LEICA MICROSYSTEMS PRODUCT PORTFOLIO 175 TABLE 115 LEICA MICROSYSTEMS RECENT DEVELOPMENTS ( ) 175 TABLE 116 MIZUHO OSI PRODUCT PORTFOLIO 177 TABLE 117 MIZUHO OSI RECENT DEVELOPMENTS ( ) 177 TABLE 118 PHILIPS HEALTHCARE PRODUCT PORTFOLIO 178 TABLE 119 PHILIPS HEALTHCARE RECENT DEVELOPMENTS ( ) 179 TABLE 120 SIEMENS HEALTHCARE PRODUCT PORTFOLIO 180 TABLE 121 SIEMENS HEALTHCARE RECENT DEVELOPMENTS ( ) 181 TABLE 122 SKYTRON PRODUCT PORTFOLIO 183 TABLE 123 SKYTRON RECENT DEVELOPMENTS ( ) 183 TABLE 124 SMITH & NEPHEW PRODUCT PORTFOLIO 184 TABLE 125 SMITH & NEPHEW RECENT DEVELOPMENTS ( ) 184 TABLE 126 SONY MEDICAL PRODUCT PORTFOLIO 186 TABLE 127 SONY MEDICAL RECENT DEVELOPMENTS ( ) 186 TABLE 128 STERIS PRODUCT PORTFOLIO

16 TABLE HEADING TABLE 129 STERIS RECENT DEVELOPMENTS ( ) 187 TABLE 130 STRYKER PRODUCT PORTFOLIO 188 TABLE 131 STRYKER RECENT DEVELOPMENTS ( ) 188 TABLE 132 OLYMPUS PRODUCT PORTFOLIO 190 TABLE 133 OLYMPUS RECENT DEVELOPMENTS ( ) 191 TABLE 134 TOSHIBA MEDICAL SYSTEMS PRODUCT PORTFOLIO 192 TABLE 135 TOSHIBA MEDICAL SYSTEMS RECENT DEVELOPMENTS ( ) 192 TABLE 136 TRUMPF PRODUCT PORTFOLIO 193 TABLE 137 TRUMPF RECENT DEVELOPMENTS ( ) 193 TABLE 138 NDS SURGICAL IMAGING PRODUCT PORTFOLIO 194 TABLE 139 NDS SURGICAL IMAGING RECENT DEVELOPMENTS ( ) 195 TABLE 140 U.S. PATENT LIST, TABLE 141 EUROPEAN PATENT LIST, TABLE 142 JAPAN PATENT LIST,

17 LIST OF FIGURES FIGURE TITLE SUMMARY FIGURE GLOBAL OPERATING ROOM MARKET BY REGION, ($ FIGURE 1 ROLES OF STAKEHOLDERS IN THE OR MARKET 32 FIGURE 2 ROLES OF STAKEHOLDERS IN THE OR MARKET 34 FIGURE 3 CURRENT AND FUTURE OR MARKETS, 2011-APRIL FIGURE 4 RECENT DEVELOPMENTS BY COMPANIES, 2011-APRIL 2014 (%) 37 FIGURE 5 NUMBER OF OR PATENTS BY YEAR 38 FIGURE 6 NUMBER OF OR PATENTS BY REGION 2007 TO APRIL 2014 (%) 39 FIGURE 7 NUMBER OF OR PATENTS BY TECHNOLOGY 2007 TO APRIL 2014 (%) 40 FIGURE 8 ADOPTION OF DIAGNOSTIC IMAGING TECHNOLOGIES IN CANADA, 2003 AND 2008 ($ FIGURE 9 TYPES OF SURGERIES PERFORMED IN ASCS IN THE U.S. (%) 112 FIGURE 10 NEW PRODUCT DEVELOPMENT BY COMPANY, (%) 118 FIGURE 11 MERGERS AND ACQUISITIONS BY COMPANY, (%) 125 FIGURE 12 PRODUCT CERTIFICATIONS AND APPROVALS BY COMPANY, (%) FIGURE 13 JOINT VENTURES BY COMPANY, (%) 131 FIGURE 14 PATIENTS USING SURGICAL FACILITIES BY AGE GROUP IN THE U.S. (%) 139 FIGURE 15 NUMBER OF OPERATING ROOMS PER 100,000 POPULATION IN EUROPE, 2010 FIGURE 16 NUMBER OF OPERATION ROOMS PER 100,000 POPULATION IN ASIA-PACIFIC FIGURE 17 ESTIMATED NUMBER OF ORS PER 100,000 PEOPLE IN LATIN AMERICA AND THE CARIBBEAN FIGURE 18 U.S. PATENTS BY TECHNOLOGY, (%) 155 FIGURE 19 U.S. PATENTS BY COMPANY, (%) 156 FIGURE 20 EUROPEAN PATENTS BY TECHNOLOGY, (%) 157 FIGURE 21 EUROPEAN PATENTS BY COMPANIES, (%) 157 FIGURE 22 JAPAN PATENTS BY TECHNOLOGY, (%) 158 FIGURE 23 JAPAN PATENTS BY COMPANY, (%)

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