| Study Period | 2019 - 2032 |
| Market Size in 2024 | USD 370.2 Million |
| Market Size in 2025 | USD 387.2 Million |
| Market Size by 2032 | USD 565.9 Million |
| Projected CAGR | 5.6% |
| Largest Region | North America |
| Fastest Growing Region | APAC |
| Market Structure | Consolidated |
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The endoscopic submucosal dissection market size was USD 370.2 million in 2024, which is predicted to reach USD 565.9 million by 2032, growing at a CAGR of 5.6% during 2025–2032.
Endoscopic submucosal dissection (ESD) procedures are used to remove various lesions and tumors in the submucosa. It is comparatively more effective for eliminating certain growths that have clear borders or those that are too large to remove in one piece by other methods. In these cases, ESDs can help in minimizing the risk of the spread of cancer in Japan. This procedure, which involves a large and deep esophageal wall resection via the dissection of the submucosal connective tissue just beneath the target lesion from the underlying muscle layer, with the help of electrocautery devices, such as a hook knife, is becoming increasingly popular.
Endoscopists have started to accept this procedure worldwide, although it is the most frequently performed in APAC, especially for the early neoplasia of the esophagus, stomach, colon, and rectum. Its key benefit is the ability to remove larger lesions en bloc in the plane between the muscularis propria and the submucosa. There are many forms of ESDs, including endoscopic submucosal tunneling, or, in select cases, even a full-thickness resection.
As the geriatric population is increasing, a rise in the number of patients riddled with target diseases and those being treated with antithrombotic drugs has been seen. The ESD is a comparatively safe technique on super-elderly patients suffering from early-stage gastric cancer. It is less invasive than open surgical procedures and highly advantageous in terms of organ preservation.
The knives category will grow at the highest CAGR, of 6.5%, during the forecast period. This will mainly be due to the availability of a wide range of surgical knives, which are, additionally, evolving rapidly for higher efficacy, safety, and cost-effectiveness. A variety of I knives and O knives are available to resect different kinds of tissues.
Moreover, tissue retractors also held a significant share in the market. This is mainly attributed to the increasing number of surgical procedures and technological advancements, including robotic surgery, telesurgery, and multi-angle rear-viewing endoscopic tool (MARVEL). Surgical robots consist of several arms, one with a camera and others attached to surgical instruments. These robots provide more precision for a more-minimally invasive procedure, as well as faster recoveries, smaller incisions and scars, and reduced blood loss and risk of infections.
Telesurgery has been one of the greatest advancements in the field of surgery. With this, surgeons can operate from anywhere, with the help of surgical robots. This technology has become even more popular during the COVID-19 outbreak.
The products analyzed here are:
The stomach cancer category held the largest market share, of 55%, in 2024. This is mainly due to the intake of large amounts of foods preserved by salting, such as salted fish and meats and pickled vegetables. In the U.S., stomach cancer is one of the leading causes of death; each year, it accounts for almost 2% of all new cancers. In the country, stomach cancer primarily begins in the gastroesophageal junction.
Moreover, obesity is one of the key causes of stomach cancer. In the U.K., around 5 out of 100 stomach cancer cases are caused by obesity. In 2021, more than 25% of the adults in the U.K. were obese, and around 40% more were overweight. Additionally, each year, Japan organizes a national endoscopic surveillance program due to the high stomach cancer risk. It has been suggested that every year, people who are older than 40 years undergo screening with endoscopy and a double-contrast barium X-ray.
The indications analyzed here are:
The hospitals category held the largest market share, of 60%, in 2024, due to the fact that various hospitals worldwide are opting for this procedure as it less invasive. For instance, in February 2023, Mediclinic Parkview Hospital in the U.A.E. launched endoscopic submucosal dissection services. This new minimally invasive procedure will positively impact the wellbeing of patients who could require surgical intervention, such as a colon, esophageal, or stomach resection, which can lead to further lifestyle complications.
Moreover, in 2020, in India, KMC Hospital performed an endoscopic procedure on a large tumor, which was present in the stomach of a 40-year-old woman. The tumor was removed via the mouth, without any surgery or external scar.
Further, various investments are being done in this area to make the procedure easily accessible, more effective, and safer. For instance, in 2021, Scope Investment, a private investment firm based in the U.A.E., partnered with the Asan Medical Center (AMC) Hospital in South Korea to open GCC’s first comprehensive GI hospital in the U.A.E. for GI cancer procedures, such as ESD, EMR, and ERCP.
The end users analyzed here are:
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North America held the largest market share, of 45%, in 2024. This dominance is primarily driven by the region's well-established healthcare infrastructure, early adoption of advanced endoscopic technologies, and high procedural awareness among clinicians. The United States leads the regional landscape due to its strong reimbursement ecosystem, widespread implementation of screening programs for early-stage gastrointestinal cancers, and availability of skilled endoscopists in tertiary care centers.
Moreover, the presence of major medical device manufacturers and ongoing investment in endoscopy-related research and development continue to support innovation in procedural tools and imaging technologies. These factors collectively contribute to North America's leadership position in the global ESD market.
The U.S. holds the larger market share in the continent’s market. ESD is gaining importance in the U.S. for treating early gastrointestinal cancers, especially early gastric, esophageal (including Barrett’s esophagus–associated adenocarcinoma), and colorectal neoplasms. In Barrett’s patients, the annual progression rate to esophageal adenocarcinoma is roughly 0.12–0.5%. Around 27,000 new gastric cancer cases occur annually in the U.S., with early-stage lesions increasingly detected through improved screening. Colorectal cancer remains one of the most diagnosed cancers, with around 150,000 new cases annually, many suitable for endoscopic resection. Although ESD adoption in the U.S. lags behind Asia, its benefits in recurrence reduction and organ preservation are driving growth.
APAC is the fastest-growing region, with a CAGR, of 6%, during the forecast period, mainly because of the high prevalence of gastric cancer in the region. China ranks fourth and third in the world in gastric and esophageal cancer occurrence, respectively.
Due to its large population, the country has a significant number of patients with gastric and esophageal cancer. Thus, every year, the Government of China organizes an upper gastrointestinal cancer screening program in high-incidence rural areas. In this program, both the stomach and esophagus are inspected in a single endoscopy, for early cancer detection. This program covers most of the provinces of China.
The Chinese government also organizes other programs to prevent death from this type of cancer, such as the Cancer Early Diagnosis Program, Early Treatment Program in the Huai River Basin, and the Cancer Early Diagnosis and Early Treatment Program in Urban China.
Gastric cancer is the second major cause of cancer death globally. In 2021, a new study confirmed that in China, the major cause of stomach cancer is the infectious bacterium H. pylori.
Moreover, the geriatric population has been continuously increasing in Japan since 1950. In 2022, there were around 80,000 centenarians, while by 2036, people aged 65 and more will represent a third of the population. Additionally, elderly women numbered more than 20 million, accounting for more than 32% of the total female population, and the elderly male population stood at around 16 million, accounting for more than 25% of the overall male population.
Within APAC, India will have the highest CAGR during the forecast period. ESD is slowly gaining a foothold in India as a curative option for early gastrointestinal cancers—particularly early esophageal (including squamous cell types), gastric, and colorectal neoplasms. India registers approximately 279,000 new GI cancer cases per year, with esophageal (~27%), stomach (~19%), and colorectal (~9%) lesions among the most frequent indications. While early-stage detection remains limited, centers performing ESD—especially for colorectal polyps—report technical success rates above 90%, high R0 resection rates (~83%), and low recurrence (<6%) with minimal adverse events. As screening and awareness improve, ESD adoption is expected to expand across India.
The regions and countries analyzed in this report are:
The endoscopic submucosal dissection market is consolidated, primarily due to the high technical expertise and significant research and development investments required to manufacture advanced ESD devices. The market structure reflects the complexity of developing precision electrosurgical tools, high-performance endoscopic imaging systems, and reliable support accessories. Major companies maintain competitive advantages through continuous product innovation, development of training programs in collaboration with medical institutions, and strong clinical validation. Additionally, the focus on regional expansion into emerging markets and the integration of next-generation technologies such as robotic-assisted systems and artificial intelligence are shaping the future competitive dynamics of the ESD market.
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