The Most Common Surgical Procedure in LSI's Global Database

Before we dive into the most common global surgical procedure, let's answer a foundational question — why should you care about surgical procedure volumes at all?

Surgical procedure volumes are critical in determining market size for new medical devices, equipment, and services. The volumes and growth of a given procedure reflects patient demand, epidemiological trends, evolution of clinical approaches, and more.

Take an example that we explored in a previous edition of The Numbers on Ozempic and Bariatric Surgery — In 2023 alone, LSI estimated that 793,000 bariatric surgeries performed globally. This was the fastest-growing general surgery procedure by volume, however the impact of GLP-1 drugs continued to alter that playing field.

Companies need to analyze procedure volumes to identify trends, adapt their strategies, and allocate resources effectively. In the case of bariatrics, you can bet that Johnson & Johnson MedTech Intuitive , and many more are doing so.

Like any good data-driven analysis, let's establish some guardrails.

LSI 's Global Procedure Volumes Database is a trusted resource with coverage of 300+ diagnostic and therapeutic procedures in 12 major categories across 37 countries.

There are many procedures that we track which are "low complexity" and excluded from this analysis. For example, our database shows there are more than 10 million skin biopsies are performed each year.

In this edition of The Numbers, we focused on procedures with higher-complexity, requiring high levels of surgical expertise to perform.

With that being established, the highest-volume surgical procedures performed worldwide are Endoscopic procedures of the stomach and small intestine.

Let's dive in.

LSI's Global Procedure Volumes Database gives hundreds of startups and multinational companies a competitive edge in answering their most pressing questions and making data-driven decisions.

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Types of Endoscopic Procedures

Focusing on the stomach and small intestine, endoscopy plays a key role in diagnosing and treating a wide range of gastrointestinal conditions.

The main procedures include:

• Upper Endoscopy (Esophagogastroduodenoscopy, or EGD): This is the primary procedure for examining the esophagus, stomach, and duodenum. It is used to investigate symptoms like persistent abdominal pain, nausea, or unexplained weight loss and can diagnose conditions like ulcers, gastritis, and certain cancers.
• Capsule Endoscopy: Ideal for examining the small intestine, this technology uses a pill-sized camera that is swallowed by the patient to capture detailed images. It is particularly useful for identifying bleeding sources, small intestinal tumors, or Crohn’s disease.
• Double-Balloon Enteroscopy (DBE): A more specialized technique that allows direct visualization and treatment within the small intestine, often used for conditions like obscure GI bleeding, strictures, or polyps.
• Endoscopic Retrograde Cholangiopancreatography (ERCP): While primarily used for bile and pancreatic ducts, this procedure can also diagnose and treat duodenal disorders.

These procedures reduce the need for other surgical explorations, providing a less invasive alternative for diagnostics and intervention.

Conditions Diagnosed and Treated

The increasing prevalence of chronic gastrointestinal conditions is driving demand for stomach and small intestine endoscopy.

These procedures are particularly valuable for diagnosing and managing:

• Chronic GI Disorders: Conditions like Crohn’s disease, celiac disease, and small intestinal bacterial overgrowth (SIBO) are often identified using upper endoscopy or capsule endoscopy.
• GI Bleeding: Upper endoscopy and DBE are key tools for locating and treating sources of bleeding, such as ulcers or vascular lesions.
• Functional Disorders: Procedures like capsule endoscopy help identify structural abnormalities contributing to motility disorders or malabsorption syndromes.
• Infections and Inflammation: Endoscopy can detect infectious causes of gastritis or duodenitis, as well as chronic inflammation due to autoimmune conditions like celiac disease.

Biopsies obtained during endoscopy remain the gold standard for confirming many of these diagnoses, avoiding the risks and recovery time associated with surgical exploration.

The Numbers Behind GI Endoscopy

In 2024, Market Intelligence, by LSI estimated that 31.8 million endoscopic procedures of the stomach and (small) intestine were performed worldwide.

Even with the large volume of these procedures performed each year, we project that the total volume of these procedures will continue to increase at a healthy CAGR of 2.7%, reaching 36.3M procedures by 2029.

This growth is impressive when considering that total general and colorectal endoscopic procedures are projected to increase at a slightly faster CAGR of 3.0%.

The U.S. accounts for 49.2% of these procedures. With the developed healthcare infrastructure, which makes these procedures are more accessible to a larger number of patients in the U.S.

The other major factor for U.S. volume dominance is the prevalence of digestive disorders, which are higher in the U.S. as a result of relatively-poor diet and lifestyle.

However, the U.S. accounting for the majority of these procedures will diminish over the next half decade, as technology and other factors are expanding access to these procedures for patients in other countries, which we project will bring volumes more into parity.

Growth Drivers of Endoscopic Procedures

Several factors contribute to the unparalleled volume and growth of GI endoscopic procedures worldwide:

• Rising Disease Prevalence: Conditions like colorectal cancer and IBD are on the rise, increasing the demand for both diagnostic and therapeutic endoscopy.
• Aging Population: Older adults are more prone to GI conditions, increasing the need for routine screenings like colonoscopy.
• Screening Guidelines: Expanding recommendations for earlier and more frequent colorectal cancer screening are driving procedure volumes.
• Technological Advancements: Innovations such as AI-driven polyp detection, high-definition imaging, and capsule endoscopy continue to improve diagnostic accuracy and efficiency.

Looking Ahead

With the buzz around AI, endoscopy is one area where real impact is on the horizon. Enhanced polyp detection, cancer risk prediction, and streamlined procedure workflows are in reach.

This adoption feels like a logical next-step for endoscopic procedures, which serve a similar diagnostic role as radiological imaging does. Radiological imaging is currently the predominant area where AI implementation is making an impact.

New tools and techniques, such as endoscopic suturing and ablation therapies, will expand the therapeutic potential of these procedures.

Efforts to make endoscopy more accessible in underserved regions will broaden its impact, particularly in cancer prevention.

By combining diagnostic precision with therapeutic versatility, we see endoscopic procedures continuing to play an essential role in improving patient outcomes worldwide.

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Until next week,

Henry Peck and Nick Talamantes

LSI Market Intelligence Platform

All data in this article is sourced from LSI's Market Intelligence Team