Endoscopic Submucosal Dissection Knife Market Size, Share, & Trends Analysis | Global | 2026-2032

The global endoscopic submucosal dissection (ESD) knife market was valued at over $359 million in 2025. The market is projected to grow at a compound annual growth rate (CAGR) of 7.6 percent, reaching approximately $600 million by 2032.

This report covers endoscopic submucosal dissection knives, key accessories that enable minimally invasive removal of gastrointestinal lesions. It quantifies unit sales, average selling prices (ASPs), market values, growth rates, and company shares, and includes market drivers and limiters, recent mergers and acquisitions, and technology trends. The report provides historical data from 2022 to 2024 and forecasts through 2032.

The scope reflects how advancements in ESD techniques and knife designs are driving procedural adoption, improving patient outcomes, and supporting continued market expansion as hospitals and clinicians transition toward less invasive treatment pathways.

Market Overview

Endoscopic submucosal dissection (ESD) knives are designed to perform precise and controlled resections of early-stage gastrointestinal lesions, including tumors and polyps, without requiring open surgery. ESD enables physicians to dissect lesions from the submucosal layer in one piece, improving diagnostic accuracy and minimizing recurrence.

Since the introduction of ESD in the late 1990s, the procedure has evolved significantly through innovations in device design, imaging, and operator training. ESD knives have become the cornerstone of these procedures, providing the precision and versatility required for safe and effective resections.

Advances in tip design, electrical conductivity, and control mechanisms have enhanced the reliability of ESD knives, allowing physicians to achieve consistent en bloc resections with fewer complications. As more hospitals adopt ESD-capable systems and as clinician proficiency improves, the overall number of ESD procedures performed globally continues to rise.

The growing acceptance of ESD reflects the broader movement toward minimally invasive endoscopic therapies. Compared to traditional open or laparoscopic surgery, ESD offers shorter hospital stays, reduced patient discomfort, and faster recovery times. These clinical and economic benefits are expected to continue fueling market demand through 2032.

As innovations in visualization and electrosurgical technology further refine the technique, ESD is expected to become the preferred treatment for many early gastrointestinal cancers and precancerous lesions, reinforcing the importance of ESD knives within the global GI endoscopy market.

Market Drivers

Single-Fragment Resection

One of the defining advantages of ESD knives is their ability to achieve single-fragment (en bloc) resection. Removing lesions in one piece enables more accurate histological diagnosis and lowers recurrence risk compared to piecemeal resection techniques.

Clinical studies have shown that as many as 96 percent of tumors resected with ESD knives are removed in one piece, with no local recurrence observed during follow-up. The ability to secure complete resections supports improved long-term outcomes and greater confidence among physicians, making ESD knives increasingly preferred for early-stage gastrointestinal lesions.

Improved Knife Technology

• Since their first introduction in 1998, ESD knives have undergone continuous refinement. Modern knives fall into two main categories: blunt-tip designs and tip-cutting designs. Each type offers unique procedural advantages depending on lesion location and thickness of the submucosal layer.

Innovations such as rotational control, adjustable sheath lengths, and multi-functional electrodes have increased precision and reduced procedure time. Manufacturers continue to expand the range of knife tip geometries and attachments, improving versatility across lesion types and organ sites.

These improvements enhance procedural success and safety while allowing endoscopists to perform ESD with greater consistency, thereby supporting increased adoption worldwide.

Cost-Effectiveness

ESD offers comparable therapeutic outcomes to open and laparoscopic surgery but at a fraction of the cost. The ability to achieve curative resection without full surgical intervention reduces hospitalization, anesthesia requirements, and post-operative complications.

For hospitals and healthcare systems under cost constraints, ESD represents an effective alternative that delivers measurable savings while maintaining clinical efficacy. As payers and policymakers recognize these advantages, reimbursement for ESD procedures is gradually expanding across more markets. This trend further enhances the economic rationale for ESD adoption, reinforcing demand for high-quality ESD knives.

Procedural Efficiency and Training Expansion

Improved workflow efficiency and increased availability of training programs have encouraged broader physician adoption. Simulation tools, mentorship networks, and dedicated ESD courses now enable endoscopists to gain experience safely before performing procedures independently.

This investment in professional education reduces the learning curve and increases procedural success rates, supporting overall growth of the ESD market and driving higher utilization of ESD knives globally.

Market Limiters

Risk of Complications

Although ESD offers significant benefits, it carries a relatively high risk of perforation and bleeding compared to alternative procedures such as endoscopic mucosal resection (EMR). The complexity of ESD requires precise control and experience, and incomplete training can increase complication rates.

Because EMR presents a lower risk profile, some physicians still prefer it for smaller or more accessible lesions. Concerns about potential complications may limit adoption in centers with limited ESD expertise or resources.

Limited Number of ESD Experts

The successful execution of ESD requires specialized skill. In many regions, the number of trained ESD practitioners remains limited, particularly outside Japan and select academic centers in Europe and North America.

As a result, patients are often referred for surgery or EMR rather than ESD. Expanding access to training and mentorship is essential for broader adoption. Unless training opportunities increase and reimbursement policies improve, procedural volume growth may remain constrained in some markets.

Adoption Barriers and Resource Requirements

ESD procedures typically demand longer operating times and specialized equipment compared to standard endoscopic procedures. The need for dedicated electrosurgical units, advanced imaging, and anesthesia support can limit availability in lower-resource facilities.

In addition, reimbursement structures in certain markets may not yet fully cover ESD procedures, reducing incentives for hospitals to invest in the necessary infrastructure. Addressing these system-level barriers will be critical to sustaining long-term growth.

Market Coverage and Data Scope

Quantitative Coverage

Market size, market shares, market forecasts, growth rates, units sold, and average selling prices.

Qualitative Coverage

Growth trends, limiters, competitive analysis and SWOT for top competitors, mergers and acquisitions, company profiles and product portfolios, FDA recalls, disruptive technologies, and disease overviews that shape demand for ESD knives.

Time Frame

Base year 2025, forecasts 2026 to 2032, historical data 2022 to 2024.

Data Sources

Primary interviews with industry leaders, government physician data, regulatory filings, hospital procurement data, import and export databases, and the iData Research internal database.

Method Note

Revenue is modeled from units multiplied by ASP, validated against procedural data and replacement assumptions for disposable and reusable devices.

Competitive Analysis

Olympus Corporation was the leading competitor in the global ESD knife market in 2025, holding a commanding share. The company's leadership is supported by its broad product portfolio and long history in endoscopic innovation. ESD knives first gained popularity in Japan, where Olympus capitalized on early adoption to establish a dominant presence.

Among its products, the ITknife nano is particularly noteworthy. This single-use electrosurgical knife is optimized for thin submucosal layers and colon procedures, offering excellent maneuverability and infection resistance. Olympus has expanded this product line globally, reinforcing its market position through ongoing R&D and clinician training initiatives.

ERBE Elektromedizin GmbH ranked second in the ESD knife market. The company's HybridKnife combines cutting and coagulation capabilities in one instrument, enabling multiple functions without changing devices. This dual functionality simplifies inventory management for hospitals and improves procedural efficiency. The versatility of the HybridKnife and its compatibility with ERBE's advanced electrosurgical generators have helped solidify the company's position as a leading global supplier.

Boston Scientific Corporation ranked third in 2025, supported by a diverse portfolio of high-performance ESD knives. The company's product designs focus on precision, durability, and ergonomic handling, which enhance physician control during submucosal dissection. Boston Scientific continues to invest in developing ESD-specific technologies to strengthen its competitive presence in the advanced endoscopy market.

Overall, the ESD knife market is concentrated among a small group of multinational companies with established endoscopy portfolios and global distribution networks. Competition centers on innovation, training partnerships, and workflow integration, rather than price alone.

Technology and Practice Trends

Multi-functional ESD knives that combine cutting, injection, and coagulation capabilities are reducing the need for device exchanges, improving efficiency and safety.

Single-use knife designs are becoming more prevalent to prevent cross-contamination and streamline reprocessing workflows.

Advancements in tip design, such as water-jet assistance and rotatable blades, are improving precision and reducing procedure times.

Enhanced imaging integration through high-definition and narrow-band visualization systems allows for better delineation of lesion margins and submucosal layers.

Training expansion and standardization continue to drive global adoption, with simulation platforms and mentorship programs helping clinicians achieve proficiency faster.

Regional guidelines are being updated to include ESD as a first-line treatment option for early-stage gastrointestinal cancers, which is expected to further accelerate procedural growth.

Geography

This edition provides complete global coverage, including North America, Europe, Asia-Pacific, Latin America, and the Middle East & Africa.

Methodology Appendix and Acronym Glossary

Why This Report

Where are the largest and fastest-growing opportunities within the global ESD knife market

How are advancements in tip design, imaging, and procedural techniques shaping growth

Which factors are driving the shift toward minimally invasive resections and how do they impact market value

How will the expansion of training programs and cost-effectiveness of ESD influence adoption across regions

What are the key risks to growth, including procedural complexity and limited expert availability

How do Olympus, ERBE, and Boston Scientific position their portfolios and training partnerships to maintain leadership

The Global Endoscopic Submucosal Dissection Knife Market Report from iData Research answers these questions with procedure-based market models, company share analysis, and pricing data. Use it to evaluate market potential, benchmark competitive positioning, and plan strategies for entry or expansion in the advanced GI endoscopy market.