Elective surgery is the key revenue-generating source for most hospitals, ambulatory surgery centers (ASCs) and other inpatient and outpatient centers. It is estimated that up to two-thirds of hospital revenue is generated by surgical procedures. The operation room time is estimated to cost at $US15[1] per minute, resulting I up to 40% of hospital revenue, based on the case mix.
Before the pandemic, the “normal” volume of surgical procedures generated about quarter of all inpatients stays and nearly half of hospital costs [2]. A typical hospital in the United States has about 10 operation rooms (OR) and the capability to perform up to 600 cases per month, including both elective and emergency procedures. Larger hospitals might have up to 100 OR and a larger volume of elective surgeries, suffering proportionally larger losses due to procedures cancellation.
COVID-19 forced the delay and cancellation of elective procedures during the peak of the pandemic (April to June 2020), causing the MedTech industry to experience the largest decrease in surgical volumes. Consequently, the hospitals’ income has reduced dramatically, leading to massive layoffs and budget reductions.
Moreover, even after new policies and guidelines were introduced to resume surgeries during COVID-19, hospitals have faced yet another challenge of addressing the large volume of backlogged procedures and reestablishing their normal operations. The crisis in surgical revenue, combined with staffing shortages highlighted the need for scalable and efficient infrastructure to maximize capacity and provide effective resource distribution.
The main sources of surgical revenue growth focus on OR improvement and access and increasing procedure volumes. Investing in the most advanced equipment and technology allows hospitals to achieve both OR improvement and increase procedural volumes. Additionally, this investment will allow hospitals to compete against each other for both specialists and patients, as the most up-to-date technology attracts top professionals and builds patients’ trust.
Integrated and Hybrid Operating Room Overview
Chart 1: Video and Integrated Operating Room Equipment Market by Segment, Global, 2023 – 2030
Integrated and hybrid operating rooms (OR) are the latest technological advancement of hospital infrastructure. Modern integrated ORs is an operating room that has an ergonomically designed and purposely built system that increases efficiency in order to reduce procedure time and improve surgery success rates. Hybrid ORs are integrated operating rooms that include a fixed imaging system, such as a C-arm, which is often integrated with an advanced surgical table to support a variety of different procedures. Hybrid room design provides the flexibility for speedy transformation to support general surgical procedures and maximizes room use and efficiency. A full function, general purpose table can be rolled into position with full support of lights, booms and flat panel displays, while the C-arm and imaging table are stored in a low-traffic area when not in use.
An integrated OR is designed to include video, lighting, recording and information-sharing equipment integrated via a central integration component. Equipment such as surgical lighting, surgical displays, picture archiving and communication system (PACS) monitors, surgical booms, surgical tables, camera systems, lighting and image management are an integral part of a modern OR. Integrated ORs save time through their ergonomic layouts and their integrated control systems.
Over the last five years, the number of integrated operating rooms has grown steadily. Consequently, the amount of information associated with each patient, such as vital signs, diagnostic images, medical history and intraoperative images, is increasing. As technology continues to improve and more equipment is incorporated into ORs, demand for better functionality will continue to increase. Integration is becoming more common in the OR environment, creating an increasing demand for seamless integration, wireless capabilities within the OR, image quality and telemedicine.
As ORs continue to become integrated, and it becomes easier to transfer information from the OR to the rest of the hospital, demand will rise for high-quality recordings of operations. The market for image management devices is transitioning to information technology (IT) systems that are integrated with PACS and electronic medical records (EMRs) in order to record through a network. Images saved by recording devices can be used for training purposes as well as for reviewing procedures after they have been performed. Some devices can also burn images and recordings to CDs/DVDs or transfer them onto flash drives, which are then given to a patient or a professional for further review.
Among other OR equipment, surgical camera systems, light sources, surgical displays and microscopes are used primarily in minimally invasive surgeries (MIS) procedures. MIS results in faster recovery time, fewer infections and significant overall savings compared with open surgeries. As the technology continues to improve, minimally invasive techniques will be applied to additional types of procedures, resulting in increased use of corresponding OR equipment, such as surgical camera system.
Increasing demand for more efficient ORs coincides with the technological advancement of vital operating room equipment. This includes, but not limited to: the continued shift from HD to 4K technology in surgical displays and surgical camera system, the introduction of 3D technology and video microscopy, the advancement of the image-guided surgery (IGS), improved configuration of surgical booms, as well as easier-to-use user interfaces to accommodate all the components of the modern OR. Continued product innovations will drive replacement sales of the OR components, such as surgical lighting, boom, headlight, displays, camera system and microscopes, to name a few.
Competitive Landscape
Chart 2: Leading Competitors, Video and Integrated Operating Room Equipment Market, Global, 2023
Stryker
Stryker was the leading competitor of the global video endoscopy and operating room (OR) equipment market in 2023. Stryker has been in the OR business since 1992 and was among the first companies to enter the integration business. This allowed the company to amass the largest installed base in the market, with over 11,000 integrated ORs in the U.S. alone. The company benefits from its broad portfolio of high-tech integration options and OR components by offering a complete solution for a healthcare facility.
In the hybrid OR market Stryker offers SwitchPoint™ Infinity 3 Control System. The system features all of the state-of-the-art integration functions, such as surgical checklist integration, customizable room presets, quad view, centralized control and teleconferencing. These integration components utilize Stryker’s Studio™ 3 media management and ConnectSuite™ IP Video software.
Stryker was the first company to release an HD camera, in 2004, when it came out with the 1088i™ surgical camera. Since its original system launch, Stryker gained significant market share, as it was the only competitor selling an HD camera system. The company’s latest generation of HD camera is the 1488™ HD 3-chip camera system. The success of Stryker’s camera systems has driven the sales of its image management devices and surgical light source markets.
The company offers the iSuite™ integrated OR solution, which was the first integration component released. Stryker was the first entrant into the integrated OR market in 1992 and accounts for the majority of the installed base in the United States. This helps the company maintain its market share through replacement sales.
Karl Storz
Karl Storz was the second-leading competitor in the global video endoscopy and OR equipment in 2023. It was the second company to enter the integration business in 1998, which allowed it to build up the second-largest integrated OR installed base, following Stryker, with over 6,000 ORs in the United States.
Karl Storz offers the OR1™ FUSION integrated OR solution, which utilizes IP-based 4K video management technology. In addition to the hardware aspects of these OR1™ integrated OR solutions, Karl Storz also offers modular platform-independent software, such as SCENARA™.
Karl Storz’s image management device Image 1® digital platform is capable of digitally storing 4K quality images and is compatible with both 3-chip and 1-chip cameras. The Image 1® platform includes a light source, a 4K camera head, a 4K CCU, a 4K display and a digital image capture device. The system is often included with the company’s integrated OR solution, KARL STORZ OR1™.
Olympus
Olympus, the number one manufacturer of endoscopes in the world, was the third-leading competitor in the video endoscopy and OR equipment market.
Olympus released the VISERA™ 4K UHD camera system in 2015, making it one of the first companies to offer a 4K camera system. The company offers this product in a system that also includes a light source, as well as a 31” and 55” 4K display. This endoscopy cart configuration has been a successful model for Olympus as an all-in-one option for integrated ORs. The VISERA™ 4K UHD camera system supports Narrow Band Imaging (NIB), an advanced imaging technique that aids in the visualization of vascular structures on the mucosal surface.
The company offers the ORBEYE™ surgical microscope product line, which features magnification from X1 to X26. The ORBEYE™ is one of the few exoscope available in the market. The ORBEYE™ allows to eliminate traditional ocular-lens-based microscopes by providing more comfortable heads-up posture while operating. The system is compact and flexible, offering benefits for space-limited facilities, while its versatile design can be used for multiple surgical applications.
STERIS
STERIS was the fourth-leading competitor in the global video endoscopy and OR equipment market. The company also benefits from its recognized sterile processing technology and endoscopy portfolio.
STERIS has been a strong competitor within the integrated OR market since acquiring Black Diamond Video in 2015. The company offers a number of different integration systems under the Harmony IQ umbrella. It also offers the HEXAVUE™ integration system and IDSS integration system. STERIS’ integration systems are capable of accommodating 4K inputs and outputs for surgical displays and camera systems from any HDMI source. The company has ensured that its fiber optic cabling setup is also compatible with 4K signals.
The company offers the broad portfolio of surgical tables and competes in most surgical table segments. Some of its tables, such as the Amsco 3085™ General Surgical Table, can be used for a variety of different procedures. STERIS also carries orthopedic fracture tables and tables specialized for image-guided surgery (IGS), such as the company’s STERIS® OT 1000 and its SurgiGraphic® series.
Getinge
Getinge gained the fifth-leading share in the video endoscopy and OR equipment market. The company offers products in the integrated OR, hybrid OR, surgical lighting, surgical boom and surgical table segments. Getinge has partnered with Siemens, Philips, GE Healthcare and Toshiba to collaborate on hybrid OR projects and has seen a significant increase in its market share over the last few years.
Getinge offers MAGNUS™, a highly advanced integrated IGS table that features software that allows it to be integrated with the C-arm. This software was developed based on years of collaborative research done between Getinge and the large C-arm manufacturers, such as Siemens, Philips, GE and Canon. Getinge ensured that research with each of these manufacturers was done in separate projects and teams, specific to each manufacturer in order to optimize performance and efficiency. This high level of integration is the primary factor that drives up the cost of these tables, making them the most expensive and advanced surgical tables currently on the market. The integration with the C-arm distinguishes these integrated tables from the standard non-integrated IGS tables.
Recent Developments
In July 2023, Olympus announced U.S. launch of the next generation of its EASYSUITE™, the ES-IP system, a modular, scalable, workflow-based solution.
In June 2023, Olympus announced plans to establish a series of Digital Excellence Centers (DECs) following the acquisition of Odin Vision, a cloud-AI endoscopy company.
In April 2023, RIWOlink, a new independent subsidiary of Richard Wolf and Sony announced a strategic partnership to develop an advanced OR Integration technology by combining Sony’s NUCLeUS™ imaging platform and RIWOlink’s video management system.
In April 2023, Baxter showcased surgical innovations at AORN Global Surgical Conference and Expo 2023, including the Helux Pro connected surgical light.
In April 2023, Fujifilm debuted the Synapse Pathology at the Healthcare Information and Management Systems Society (HIMSS) annual meeting. The end-to-end solution is designed for medical facilities that handle large volumes of pathology images and data in multiple locations. The system delivers digital images for diagnosis 1.7 hours faster than glass slides and facilitates instant sharing of patient cases with subspecialists to enhance cross-departmental collaboration and diagnostic efficiency.
In March 2023, Skytron released the SkyVision® Ascend IP addition to its Ascend® video integration platform, featuring unlimited number of configurable inputs and outputs and full support of SD, HD and 4K and 8K architecture in place for future growth.
In February 2023, Karl Storz established a new subsidiary KARL STORZ VentureONE dedicated for robotic surgery solutions with a headquarter in Singapore and another location in Munich.
In February 2023, Baxter and Intuitive Surgical announced the TS7000dV, an integrated table motion (ITM) surgical table designed for the Da Vinci® Xi surgical system. The TS7000dV table was introduced for surgeons’ trials at the Device Technologies Asia Training Center in Singapore.
In January 2023, GE Healthcare completed the previously announced separation of its HealthCare business into a separate, independent publicly traded company
In January 2023 M&A, GE Healthcare announced the acquisition of IMACTIS.
In January 2023, Richrd Wolf announced an opening of its new independent subsidiary RIWOlink to specialize on digitization services in hospital operating theaters, especially software, hardware and services relating to networking operating theater systems, data and information management, as well as data analytics.
Closing Thought
The iData global report on the video and integrated operating room (OR) equipment market encompasses forecast and analysis of the key components of the OR, including, but not limited to, integrated and hybrid ORs, surgical displays, lighting, booms, tables, microscopes and camera systems, to name a few.
All the OR components are meant to be integrated into solid ergonomic layout to provide versatile solutions that save hospitals critical time and provide flexibility to perform a wide range of procedures with minimal adjustments. Modern integrated and hybrid ORs are built with state-of-the-art technology aiming to maximize efficiency, reduce surgery time and improve surgery success rates. The integrated ORs continue to evolve with the emergence of new technology and more efficient methods of accomplishing complex surgeries.
Moreover, integrated ORs can be connected to other areas inside and outside of the hospital. This gives surgeons the ability to consult with other professionals during the procedures and/or teach in classrooms located anywhere in the world.
About the Authors
Elena Generalova is analyst team leader at iData Research. She specialises in research projects on the medical technology industry, including the global market for video and integrated operating room equipment, among others.
Kamran Zamanian, Ph.D., is CEO and founding partner of iData Research. He has spent over 20 years working in the market research industry with a dedication to the study of medical devices used in the health of patients all over the globe.
About iData Research
For 19 years, iData Research has been a strong advocate for data-driven decision-making within the global medical device, dental and pharmaceutical industries. By providing custom research and consulting solutions, iData empowers its clients to trust the source of data and make important strategic decisions with confidence.
Additional Sources
[1] Contributing Factors to Operating Room Delays Identified from an Electronic Health Record: A Retrospective Study. Published online 2022 Sep 13. doi: 10.1155/2022/8635454.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9489409/
[2] McDermott KW (IBM Watson Health), Liang L (AHRQ). Overview of Operating Room Procedures During Inpatient Stays in U.S. Hospitals, 2018. HCUP Statistical Brief #281. August 2021. Agency for Healthcare Research and Quality, Rockville, MD.
