SURGICAL NAVIGATION SYSTEMS: TECHNOLOGIES AND GLOBAL MARKETS

Transcription

1 SURGICAL NAVIGATION SYSTEMS: TECHNOLOGIES AND GLOBAL MARKETS HLC169A August 2014 Krishanu Bhattacharjee Project Analyst ISBN: X BCC Research 49 Walnut Park, Building 2 Wellesley, MA USA (toll-free within the USA), or (+1) information@bccresearch.com

2 TABLE OF CONTENTS CHAPTER 1 INTRODUCTION 2 STUDY GOALS AND OBJECTIVES 2 REASONS FOR DOING THIS STUDY 2 INTENDED AUDIENCE 3 SCOPE OF THE REPORT 4 METHODOLOGY AND INFORMATION SOURCES 4 RELATED BCC RESEARCH REPORTS 5 ANALYST'S CREDENTIALS 5 BCC RESEARCH WEBSITE 6 DISCLAIMER 6 CHAPTER 2 SUMMARY 8 SUMMARY TABLE GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) SUMMARY FIGURE GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) 8 8 CHAPTER 3 UNDERSTANDING IMAGE-GUIDED SURGERY 11 OVERVIEW 11 WORKING PRINCIPLE OF IMAGE-GUIDED SURGERIES 11 IMAGE-FREE SURGICAL NAVIGATION 11 PARTS OF SURGICAL NAVIGATION SYSTEM 12 OVERVIEW: COMPONENTS OF SURGICAL NAVIGATION SYSTEM 12 OVERVIEW: KEY TECHNOLOGIES INVOLVED 12 Imaging Technology 12 Tracking Technology 12 Display Technology 13 Hardware 13 Software 13 UNDERSTANDING SURGERIES REQUIRING IMAGE GUIDANCE 14 ENT SURGERIES AND PROCEDURES 14 Functional Endoscopic Sinus Surgery (FESS) 14 Myringotomy 14 Mastoidectomy 15 Stapedectomy and Stapedotomy 15 Tympanoplasty 16 Types of Tympanoplasty 16 Type I Tympanoplasty 16 Type II Tympanoplasty 16 Type III Tympanoplasty 16 Type IV Tympanoplasty 17 Type V Tympanoplasty 17 Potential Complications 17 Turbinate Reduction 17 Types of Turbinate Surgery 17 Turbinectomy 17

3 Turbinoplasty 17 Radiofrequency or Laser Ablation 18 Potential Complications 18 Tonsillectomy/Adenoidectomy 18 Surgical Methods 18 Guillotine Method 18 Electrocautery 18 Dissection and Snare Method 19 Radiofrequency Ablation 19 Coblation Tonsillectomy 19 Harmonic Scalpel 19 Thermal Tissue Welding 19 Laser-Assisted Serial Tonsillectomy 19 Microdebrider 19 Plasma-Mediated Ablation 20 NEUROSURGERIES NEEDING IMAGE GUIDANCE 20 Craniotomy 20 Types of Craniotomies 20 Craniectomy 20 Endoscopic Craniotomy 20 "Eyebrow" Craniotomy (Supra-Orbital Craniotomy) 20 "Keyhole" Craniotomy (Retro-Sigmoid Craniotomy) 20 Stereotactic Craniotomy 21 Translabyrinthine Craniotomy 21 Hydrocephalus Shunting 21 Complications of Shunt System 22 SPINE SURGERIES NEEDING IMAGE GUIDANCE 23 Cervical Procedures 23 Thoracolumbar Procedures 23 Potential Complications 23 Image-Guided Spinal Surgery 24 Virtual Fluoroscopy 24 ORTHOPEDIC SURGERIES NEEDING IMAGE GUIDANCE 24 Hip Replacement 24 Complications of the Surgery 24 Image-Guided Hip Replacement 25 Knee Replacements 25 Types of Knee Replacement Surgery 26 Image-Guided Knee Replacement Surgery 26 SOFT TISSUE SURGERIES 27 Abdominal Surgeries 27 Potential Complications 27 Image-Guided Abdominal Surgery 27 Cardiovascular Surgeries 28 Image-Guided Cardiovascular Surgery 28 Transplants and Reconstructive Surgeries 28 Overview of Surgical Navigation in Ophthalmology 29

4 Image-Guided Transplant and Reconstructive Surgeries 29 SURGICAL NAVIGATION SYSTEMS: KEY MARKET SEGMENTS 30 ENT NAVIGATION SYSTEMS 30 NEUROSURGERY NAVIGATION SYSTEMS 30 SPINE NAVIGATION SYSTEMS 31 ORTHOPEDIC NAVIGATION SYSTEMS 31 OVERVIEW: SURGICAL NAVIGATION SYSTEMS ACCESSORIES MARKET 32 SURGICAL NAVIGATION SYSTEMS: KEY TECHNOLOGY SEGMENTS 33 ACTIVE AND PASSIVE NAVIGATION SYSTEMS 33 Understanding Active Navigation Systems 33 Understanding Passive Navigation Systems 33 IMAGE-GUIDED AND IMAGELESS SURGICAL NAVIGATION SYSTEMS 34 Understanding Image-Guided Surgical Navigation Systems 34 Understanding Imageless Surgical Navigation Systems 34 CHAPTER 4 GLOBAL MARKET FOR SURGICAL NAVIGATION SYSTEMS 36 MARKET DYNAMICS 36 KEY DRIVERS 36 Technological Improvements and Awareness of Utility of Navigation Systems in Soft Tissue Surgeries to Aid Adoption Rates Possibility of Significant Cost Savings Aiding Adoption Rates for Surgical Navigation Systems Medical Tourism Aiding Volume Sales of Surgical Navigation Systems in Emerging Markets Ambulatory Surgery Centers to Aid Future Sales of Navigation Systems Increasing Partnerships between Surgical Navigation and Medical Imaging Manufacturers to Aid Stronger Portfolio Creation and Sales Opportunities Improving Western European Economy to Drive Replacement Sales of Surgical Navigation Systems INDUSTRY CHALLENGES 38 Moderate Global Economic Growth Negatively Impacting Surgical Navigation Systems Market Lack of Interoperability of Navigation Systems with Surgical Instruments to Impede Adoption Workflow Related Inefficiencies of Current Surgical Navigation Products Hampering Utilization Rates Declining Number of Spine Surgeries May Delay New Installations 39 Extensive Onsite Calibration of Surgical Navigation Systems May Hamper Adoption REVENUE ANALYSIS OF THE GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET Market Summary 39 TABLE 1 GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 2 GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET BY PRODUCT SEGMENT, THROUGH 2018 ($ MILLIONS) TABLE 3 GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION

5 TABLE 4 GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET SHARES BY COUNTRY/REGION, 2013 VS 2018 (%) TECHNOLOGY TRENDS 42 Gradual Increase in Frameless Stereotaxy for Intracranial Procedures 42 7D Surgical Navigation System for Faster Visualization of Sub-Surface Area in Image-Guided Surgeries Marker-Free Registration for Accurate Integration of CT Images 43 Co-registration of Data from Multiple Sources in Neurosurgical Navigation System MRI-guided Neurosurgical Navigation and Virtual Reality in Surgical Navigation Surgeries Development of 3D-2D Registration for Better Precision in Surgical Navigation Surgeries Development of Fluorescence-Based Molecular Navigation for Cancer Surgery Clearance of New Handheld Navigation Device for Application in Total Hip and Total Knee Arthroplasty Surgeries Lung Navigation System for Screening and Diagnosis of Lung Cancer 46 3D Surgical Navigation Technology for Cataract Surgery Being Licensed PATENT AND PATENT APPLICATION ANALYSIS CHAPTER 5 SURGICAL NAVIGATION SYSTEMS MARKET BY COUNTRY 51 SURGICAL NAVIGATION SYSTEMS MARKET IN THE U.S. 51 HEALTHCARE SYSTEM AND REGULATORY POLICIES 51 MARKET OPPORTUNITIES AND RISKS IN THE U.S. 51 Rise in Total Hip, Total Knee and Partial Knee Arthroplasty Procedures Likely to Drive Surgical Navigation Systems Market Improved Awareness of Clinical Benefits Associated with ENT Surgical Navigation to Aid Adoption Rates Development of Low Cost ENT Navigation Systems to Propel Revenue Growth Surgery-Based Fixed Reimbursements to Restrict the Growth of Surgical Navigation Systems Market in the U.S. REVENUE FORECASTS 53 TABLE 5 REVENUE FORECAST FOR THE U.S. SURGICAL NAVIGATION SYSTEMS MARKET BY PRODUCT SEGMENT, THROUGH 2018 ($ MILLIONS) TABLE 6 U.S. SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY PRODUCT SEGMENT, 2013 VS 2018 (%) SURGICAL NAVIGATION SYSTEMS MARKET IN CANADA 54 HEALTHCARE SYSTEM AND REGULATORY POLICIES 54 MARKET OPPORTUNITIES AND RISKS IN CANADA 55 Increasing Outpatient Spine Surgery May Increase the Use of Surgical Navigation Systems in Canada Inclusion of Hip and Knee Replacement Procedures in Quality Based Procedures Likely to Boost Unit Sales of Orthopedic Surgical Navigation Systems Long Wait Time for Hip and Knee Replacement Surgeries in Canada May Drive the Growth of Image-Free Surgical Navigation Market REVENUE FORECASTS

6 TABLE 7 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN CANADA, THROUGH 2018 ($ MILLIONS) TABLE 8 CANADIAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE SURGICAL NAVIGATION SYSTEMS MARKET IN JAPAN 57 HEALTHCARE SYSTEM AND REGULATORY POLICIES 57 MARKET OPPORTUNITIES AND RISKS IN JAPAN 58 Growing Elderly Population in Japan Likely to Aid the Demand for Minimally Invasive Surgeries Growing Procedural Volumes and Extended Usage of Image-Guided Surgeries Likely to Propel Sales of Surgical Navigation Systems Pressure on Government Healthcare Spending is Likely to Impede the Growth of Surgical Navigation Systems REVENUE FORECASTS 58 TABLE 9 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN JAPAN, THROUGH 2018 ($ MILLIONS) TABLE 10 JAPANESE SURGICAL NAVIGATION SYSTEMS MARKET SHARE SURGICAL NAVIGATION SYSTEMS MARKET IN FRANCE 59 HEALTHCARE SYSTEM AND REGULATORY POLICIES 59 MARKET OPPORTUNITIES AND RISKS IN FRANCE 60 R&D in the Application of Image Guidance to Gastroenterology and Other Specialties to Widen Sales of Surgical Navigation Systems Increasing Number of Orthopedic Surgeries to Promote Growth of Orthopedic Navigation Systems Increased Adoption of Endoscopic Techniques for ENT Surgeries to Aid Market Growth Plunging French Economy May Impede the Purchase of Middle and High-End Surgical Navigation Systems REVENUE FORECASTS 61 TABLE 11 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN FRANCE BY PRODUCT SEGMENT, THROUGH 2018 ($ MILLIONS) TABLE 12 FRENCH SURGICAL NAVIGATION SYSTEMS MARKET SHARE SURGICAL NAVIGATION SYSTEMS MARKET IN GERMANY 62 HEALTHCARE SYSTEM AND REGULATORY POLICIES 62 MARKET OPPORTUNITIES AND RISKS IN GERMANY 63 Increasing Hip Replacement and Knee Replacement Surgeries in Germany to Drive Market Growth Reforms in German Healthcare Policy Likely to Boost Adoption of Surgical Navigation Systems Truncated Funding for the Purchase of New Medical Devices to Impede Expansion of Surgical Navigation Systems in Germany REVENUE FORECASTS 64 TABLE 13 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN GERMANY, THROUGH 2018 ($ MILLIONS) TABLE 14 GERMAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE SURGICAL NAVIGATION SYSTEMS MARKET IN ITALY 65 HEALTHCARE SYSTEM AND REGULATORY POLICIES 65 MARKET OPPORTUNITIES AND RISKS IN ITALY

7 Research on the Application of Image Guidance in General Surgeries and Stereotactic Radio-Surgical Procedures May Aid Revenue Growth Rise in the Volume of Spine and Orthopedic Procedures May Increase the Sale of Surgical Navigation Systems in Italy Growing Aging Population in Italy May Boost the Usage of Surgical Navigation Systems across All Specialties Restructuring of Healthcare Policies Attributable to Financial Austerity Measures May Negatively Impact Revenue Growth REVENUE FORECASTS 67 TABLE 15 REVENUE FORECASTS FOR THE ITALIAN SURGICAL NAVIGATION TABLE 16 ITALIAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION SURGICAL NAVIGATION SYSTEMS MARKET IN SPAIN 68 HEALTHCARE SYSTEM AND REGULATORY POLICIES 68 MARKET OPPORTUNITIES AND RISKS IN SPAIN 68 Increasing Awareness of Image-Guided Surgeries in Orthopedic Procedures Likely to Aid Penetration Rates Growth in Spine, Neuro and Orthopedic Surgeries Likely to Drive the Surgical Navigation Systems Market Healthcare Reforms Such as Centralized Purchasing Procedure for Hospitals May Impede Manufacturers' Profits from Navigation Systems REVENUE FORECASTS 69 TABLE 17 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN SPAIN, THROUGH 2018 ($ MILLIONS) TABLE 18 SPANISH SURGICAL NAVIGATION SYSTEMS MARKET SHARE SURGICAL NAVIGATION SYSTEMS MARKET IN THE U.K. 70 HEALTHCARE SYSTEM AND REGULATORY POLICIES 70 England 71 Wales 71 Scotland 71 Ireland 71 MARKET OPPORTUNITIES AND RISKS IN THE U.K. 71 Best Practice Tariff Likely to Drive the Growth of Surgical Navigation in Ambulatory Surgery Facilities Effective Usage of Outpatient Operating Rooms May Result in Increased Adoption of Surgical Navigation Systems Increased Investment by Welsh Government in Orthopedic Services Likely to Boost the Sales of Surgical Navigation Systems Increase in the Number of Neurosurgical Procedures in the U.K. to Drive Sales of Surgical Navigation Systems REVENUE FORECASTS 73 TABLE 19 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN THE U.K., THROUGH 2018 ($ MILLIONS) TABLE 20 U.K. SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY PRODUCT SEGMENT, 2013 VS 2018 (%) SURGICAL NAVIGATION SYSTEMS MARKET IN BRAZIL 74 HEALTHCARE SYSTEM AND REGULATORY POLICIES 74 MARKET OPPORTUNITIES AND RISKS IN BRAZIL

8 Increased Education, Awareness and Research in Image-Guided Surgeries Likely to Aid Adoption of Surgical Navigation Systems Increasing Procedural Volumes of Spine and Orthopedic Surgery May Drive the Growth of Surgical Navigation Systems Increased Government Spending on Healthcare May Boost the Growth of Surgical Navigation Systems in Brazil High Import Taxes in Brazil Likely to Hinder the Growth of Capital-Intensive Surgical Navigation Systems REVENUE FORECASTS 76 TABLE 21 REVENUE FORECASTS FOR THE BRAZILIAN SURGICAL NAVIGATION TABLE 22 BRAZILIAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE SURGICAL NAVIGATION SYSTEMS MARKET IN CHINA 77 HEALTHCARE SYSTEM AND REGULATORY POLICIES 77 MARKET OPPORTUNITIES AND RISKS IN CHINA 78 Increasing Government Funds and Healthcare Reforms Likely to Aid Revenue Growth Exponential Growth of the Private Hospitals Market in China to Drive the Addressable Market for Surgical Navigation Systems Reforms in Healthcare Policies to Drive the Growth of Surgical Navigation System Increased Capital Investment to Set Up High-End Private Hospitals and Specialty Clinics to Fuel the Growth of Surgical Navigation Systems Market Local Competition May Pose Pricing Constraints for Global Manufacturers REVENUE FORECASTS 79 TABLE 23 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN CHINA, THROUGH 2018 ($ MILLIONS) TABLE 24 CHINESE SURGICAL NAVIGATION SYSTEMS MARKET SHARE SURGICAL NAVIGATION SYSTEMS MARKET IN INDIA 80 HEALTHCARE SYSTEM AND REGULATORY POLICIES 80 MARKET OPPORTUNITIES AND RISKS IN INDIA 81 Medical Tourism Driving Volume Sales for Navigation Systems in India Need for High-End Surgical Infrastructure for Beating Competition Promoting Revenue Growth in the Private Sector Growing Number of Orthopedic Surgeries to Continue Driving Sales of Surgical Navigation Systems Lack of Adequate Impetus in ENT Surgeries to Negatively Impact Growth of Navigation Systems REVENUE FORECASTS 82 TABLE 25 REVENUE FORECASTS FOR THE INDIAN SURGICAL NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 26 INDIAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION SURGICAL NAVIGATION SYSTEMS MARKET IN AUSTRALIA AND NEW ZEALAND 83 HEALTHCARE SYSTEM AND REGULATORY POLICIES 83 Healthcare System in Australia

9 Healthcare System in New Zealand 84 MARKET OPPORTUNITIES AND RISKS 84 Need for Cutting-Edge Technology in Orthopedic Surgeries to Drive Market Growth in Australia Private Hospitals to Drive Volume Sales in Australia and New Zealand 85 Budget Cuts for Public Hospitals to Impact Revenue Growth of Navigation Systems in the Long-Term Future REVENUE FORECASTS 85 TABLE 27 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN AUSTRALIA AND NEW ZEALAND, THROUGH 2018 ($ MILLIONS) TABLE 28 AUSTRALIAN AND NEW ZEALAND SURGICAL NAVIGATION SYSTEMS MARKET SHARE SURGICAL NAVIGATION SYSTEMS MARKET IN SOUTH KOREA 87 HEALTHCARE SYSTEM AND REGULATORY POLICIES 87 MARKET OPPORTUNITIES AND RISKS IN SOUTH KOREA 87 Rising Medical Tourism Industry May Augment Demand for Surgical Navigation Systems Extended Application of Surgical Navigation Systems to Additional Specialties Likely to Aid Market Expansion Higher Expendable Incomes of South Korean Population to Aid Market Growth High Cost of Installation and Lower Reimbursement Rates to Impede Market Growth REVENUE FORECASTS 88 TABLE 29 REVENUE FORECASTS FOR THE SOUTH KOREAN SURGICAL NAVIGATION TABLE 30 SOUTH KOREAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE SURGICAL NAVIGATION SYSTEMS MARKET IN THE REST OF THE WORLD 89 REVENUE FORECASTS 89 TABLE 31 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN THE REST OF THE WORLD, THROUGH 2018 ($ MILLIONS) TABLE 32 REST OF THE WORLD SURGICAL NAVIGATION SYSTEMS MARKET SHARE CHAPTER 6 ENT NAVIGATION SYSTEMS 92 MARKET DYNAMICS 92 MARKET LANDSCAPE 92 MARKET DRIVERS 92 Neurosurgeons Influence on Purchase Decision Aiding Market Growth in Emerging Markets Growing Awareness of the Benefits of Navigation Systems in ENT Promoting Volume Sales Availability of Low-Priced Systems Aiding Overall Penetration of ENT Navigation Systems INDUSTRY CHALLENGES 93 Restricted Use of Navigation Systems in ENT Procedures Hampering Adoption Limited Hospital Budgets for ENT Department Impeding Revenue Growth

10 Lack of Reimbursement for Navigation Enabled ENT Procedures Limiting Volume Sales Lack of Clinical Effectiveness Data Hampering Market Penetration 94 GLOBAL ENT NAVIGATION SYSTEMS MARKET: REVENUE ANALYSIS AND FORECASTS TABLE 33 REVENUE FORECASTS FOR THE GLOBAL ENT NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 34 ENT SURGICAL NAVIGATION SYSTEMS MARKET SHARES BY COUNTRY/REGION, 2013 VS 2018 (%) MAJOR STRATEGIC INITIATIVES AND COMPETITIVE LANDSCAPE CHAPTER 7 NEUROSURGERY NAVIGATION SYSTEMS 99 MARKET DYNAMICS 99 MARKET LANDSCAPE 99 MARKET DRIVERS 99 Demand for Replacement of Existing Units Driving Developed Markets Clinical Utility in Complex Brain Procedures Aiding Penetration and Subsequent Utilization Improved Awareness among Neurosurgeons Aiding Revenue Growth 100 Medical Tourism Aiding Market Penetration in Emerging Markets 100 Need for Electromagnetic Tracking Promoting Volume Sales 100 Demand for Intraoperative MRI to Boost Future Sales 101 INDUSTRY CHALLENGES 101 Concerns around Brain Shift Hampering Adoption Rates 101 Justifying High Cost of Navigation Systems in Relation to Patient Outcomes Slowing Down Adoption GLOBAL NEUROSURGERY NAVIGATION SYSTEMS MARKET: REVENUE ANALYSIS AND FORECASTS TABLE 35 REVENUE FORECASTS FOR THE GLOBAL NEUROSURGICAL NAVIGATION TABLE 36 NEUROSURGERY NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY COUNTRY/REGION, 2013 VS 2018 (%) MAJOR STRATEGIC INITIATIVES AND COMPETITIVE LANDSCAPE CHAPTER 8 SPINE NAVIGATION SYSTEMS 105 MARKET DYNAMICS 105 MARKET LANDSCAPE 105 MARKET DRIVERS 105 Increasing Number of Spine Clinics Aiding Volume Sales 105 Enhanced Clinical Outcomes and Financial Incentives Aiding Business Growth in the Spinal Segment Increased Adoption of Intraoperative Imaging Promoting Market Growth INDUSTRY CHALLENGES 106 Reimbursement Cuts Negatively Impacting Revenue Growth 106 Growing Concerns around Overutilization of Spine Surgeries May Slow Market Growth Lack of Training and Clinical Data Supporting Efficacy of Navigation Systems Impeding Adoption Rates

11 Moderate Decrease in Spine Surgery Volumes May Negatively Impact Volume Sales in Developed Markets GLOBAL SPINE NAVIGATION SYSTEMS MARKET: REVENUE ANALYSIS AND FORECAST TABLE 37 REVENUE FORECAST FOR THE GLOBAL SPINE NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 38 GLOBAL SPINE NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY COUNTRY/REGION, 2013 VS 2018 (%) MAJOR STRATEGIC INITIATIVES AND COMPETITIVE LANDSCAPE CHAPTER 9 ORTHOPEDIC NAVIGATION SYSTEMS 111 MARKET LANDSCAPE 111 MARKET DRIVERS 111 Increasing Demand for Minimally Invasive Surgeries Aiding Volume Sales Growing Demand for Hip and Knee Replacements to Boost Volume Sales Improved Adoption of Kinematic Assessment Using Navigation Systems to Aid Penetration Need for State-of-the-Art Technology in Emerging Markets to Aid Volume Sales INDUSTRY CHALLENGES 112 Increased Time for the Overall Procedure Using Navigation Systems Impacting Penetration Installation of Systems for Free Reducing Overall System Utilization and Revenue Growth GLOBAL ORTHOPEDIC NAVIGATION SYSTEMS MARKET: REVENUE ANALYSIS AND FORECASTS TABLE 39 REVENUE FORECAST FOR THE GLOBAL ORTHOPEDIC NAVIGATION TABLE 40 GLOBAL ORTHOPEDIC NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY COUNTRY/REGION, 2013 VS 2018 (%) MAJOR STRATEGIC INITIATIVES AND COMPETITIVE LANDSCAPE CHAPTER 10 COMPETITIVE LANDSCAPE 117 MARKET SHARE ANALYSIS 117 TABLE 41 MARKET SHARE ANALYSIS OF THE GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET, 2013 (%) COMPANY AND PRODUCT PROFILES 118 AESCULAP (B. BRAUN) 118 Company Profile 118 Product Profile 118 AMPLITUDE 119 Company Profile 119 Product Profile 119 CLARON TECHNOLOGIES INC. 119 Company Profile 119 Product Profile 120 COLLIN MEDICAL 120 Company Profile

12 Product Profile 120 COMPASS INTERNATIONAL INNOVATIONS 120 Company Profile 121 Product Profile 121 FIAGON GMBH 121 Company Profile 121 Recent Activities 122 Product Profile 122 KARL STORZ 122 Company Profile 122 Product Profile 123 MEDACTA INTERNATIONAL 123 Company Profile 123 Product Profile 123 MEDTRONIC 123 Company Profile 123 Product Profile 124 MICROMAR 124 Company Profile 125 Product Profile 125 PARITIC 125 Company Profile 125 Product Profile 125 PATHFINDER TECHNOLOGIES 126 Company Profile 126 Recent Activities 126 Product Profile 127 OMNILIFE SCIENCE INC. 127 Company Profile 127 Product Profile 128 SCOPIS 128 Company Profile 128 Recent Activities 128 Product Profile 129 SIEMENS AG 129 Company Profile 129 Product Profile 129 STRYKER 129 Company Profile 130 Product Profile 130 ZIMMER 130 Company Profile 130 Product Profile 131

13 LIST OF TABLES TABLE HEADING SUMMARY TABLE GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 1 GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 2 GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET BY PRODUCT SEGMENT, THROUGH 2018 ($ MILLIONS) TABLE 3 GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION TABLE 4 GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET SHARES BY COUNTRY/REGION, 2013 VS 2018 (%) TABLE 5 REVENUE FORECAST FOR THE U.S. SURGICAL NAVIGATION SYSTEMS MARKET BY PRODUCT SEGMENT, THROUGH 2018 ($ MILLIONS) TABLE 6 U.S. SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY PRODUCT SEGMENT, 2013 VS 2018 (%) TABLE 7 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN CANADA, THROUGH 2018 ($ MILLIONS) TABLE 8 CANADIAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION TABLE 9 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN JAPAN, THROUGH 2018 ($ MILLIONS) TABLE 10 JAPANESE SURGICAL NAVIGATION SYSTEMS MARKET SHARE TABLE 11 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN FRANCE BY PRODUCT SEGMENT, THROUGH 2018 ($ MILLIONS) TABLE 12 FRENCH SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION TABLE 13 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN GERMANY, THROUGH 2018 ($ MILLIONS) TABLE 14 GERMAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION TABLE 15 REVENUE FORECASTS FOR THE ITALIAN SURGICAL NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 16 ITALIAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION TABLE 17 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN SPAIN, THROUGH 2018 ($ MILLIONS) TABLE 18 SPANISH SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION TABLE 19 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN THE U.K., THROUGH 2018 ($ MILLIONS) TABLE 20 U.K. SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY PRODUCT SEGMENT, 2013 VS 2018 (%) TABLE 21 REVENUE FORECASTS FOR THE BRAZILIAN SURGICAL NAVIGATION TABLE 22 BRAZILIAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE TABLE 23 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN CHINA, THROUGH 2018 ($ MILLIONS) TABLE 24 CHINESE SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION

14 TABLE HEADING TABLE 25 REVENUE FORECASTS FOR THE INDIAN SURGICAL NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 26 INDIAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION TABLE 27 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN AUSTRALIA AND NEW ZEALAND, THROUGH 2018 ($ MILLIONS) TABLE 28 AUSTRALIAN AND NEW ZEALAND SURGICAL NAVIGATION SYSTEMS MARKET SHARE TABLE 29 REVENUE FORECASTS FOR THE SOUTH KOREAN SURGICAL NAVIGATION TABLE 30 SOUTH KOREAN SURGICAL NAVIGATION SYSTEMS MARKET SHARE TABLE 31 REVENUE FORECASTS FOR THE SURGICAL NAVIGATION SYSTEMS MARKET IN THE REST OF THE WORLD, THROUGH 2018 ($ MILLIONS) TABLE 32 REST OF THE WORLD SURGICAL NAVIGATION SYSTEMS MARKET SHARE TABLE 33 REVENUE FORECASTS FOR THE GLOBAL ENT NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 34 ENT SURGICAL NAVIGATION SYSTEMS MARKET SHARES BY COUNTRY/REGION, 2013 VS 2018 (%) TABLE 35 REVENUE FORECASTS FOR THE GLOBAL NEUROSURGICAL NAVIGATION TABLE 36 NEUROSURGERY NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY COUNTRY/REGION, 2013 VS 2018 (%) TABLE 37 REVENUE FORECAST FOR THE GLOBAL SPINE NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) TABLE 38 GLOBAL SPINE NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY COUNTRY/REGION, 2013 VS 2018 (%) TABLE 39 REVENUE FORECAST FOR THE GLOBAL ORTHOPEDIC NAVIGATION TABLE 40 GLOBAL ORTHOPEDIC NAVIGATION SYSTEMS MARKET SHARE DISTRIBUTION BY COUNTRY/REGION, 2013 VS 2018 (%) TABLE 41 MARKET SHARE ANALYSIS OF THE GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET, 2013 (%)

15 LIST OF FIGURES FIGURE TITLE SUMMARY FIGURE GLOBAL SURGICAL NAVIGATION SYSTEMS MARKET, THROUGH 2018 ($ MILLIONS) 8