Submucosal injections are gaining immense role in endoscopic therapeutic procedures and their management of various gastro enterological diseases, these trends will burgeon the market for submucosal injection products in coming pledge. The importance of submucosal injection becomes apparent in the context of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), two endoscopic therapeutic methods designed to remove lesions where the underlying mucosa is raised in order to achieve a safe and successful removal.
Increasing incidence of diseases such as gastric tumors and colorectal cancer have led to high demand for such procedures which will contribute to the growth of the submucosal injections market. Furthermore, the overall improvement in the safety and efficacy profile of these procedures due to technological advancements and development of new injectable agents in order to create synergies is expected to further complement the growth of the market. The market is expected to grow USD 4,439.5 Million, at a CAGR of 5.6% from 2,574.5 Million in 2025.
Key Market Metrics
| Metric | Value |
|---|---|
| Market Size in 2025 | USD 2,574.5 Million |
| Projected Market Size in 2035 | USD 4,439.5 Million |
| CAGR (2025 to 2035) | 5.6% |
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North America represents a substantial share of the global submucosal injections market, owing to the availability of sophisticated healthcare infrastructure coupled with high prevalence of gastrointestinal disorders.
The amount of high priority afforded to early diagnosis and the use of a range of advanced endoscopic techniques also contributes to expanding the market growth throughout the Asia Pacific region. In addition, favourable reimbursement policies combined with significant investments in research and development are enabling introduction of novel injection agents which further propel the market.
Europe submucosal injections market is experiencing a good growth because of the growing number of endoscopic procedures as well as the rising incidence of minimally invasive procedures.
Other countries, including Germany, France, the United Kingdom and others, are ahead of the curve with health care delivery systems that emphasize the early detection and treatment of gastrointestinal disease. Collaborations between research centers and medical device companies are also speeding up the development and adoption of new submucosal injection solutions.
Asia Pacific is expected to register the fastest CAGR during the forecast period due to rising prevalence of gastrointestinal diseases along with improving healthcare infrastructure coupled with rising healthcare expenditure. China, Japan and India are prioritising the better accessibility and economy of medical care, leading to a growing popularity of endoscopic procedures that require submucosal injections. This region is projected to observe market growth as a result of rising awareness campaigns along with government initiatives to control gastrointestinal disorders.
Challenges
Technical Complexity, High Procedure Costs, and Limited Practitioner Expertise
Technical complexity of procedures is a major challenge faced by the submucosal injections market involving complex endoscopic procedures. Procedures like endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and endoscopic tumor ablation depend on highly skilled practitioners, thus not widely used.
Moreover, the high costs of equipment and consumables, for example, specialized injectors, viscous injection fluids, and electrosurgical devices, can preclude access at smaller or low-resource hospitals in particular. Lack of training consistency and limited access to simulation-based learning has been prevented the expansion of submucosal injection skills globally.
Opportunities
Endoscopic Innovation, Minimally Invasive Therapies, and Next-Gen Injection Fluids
The market is being driven by favorable trends toward minimally invasive procedures, especially in the case of gastrointestinal oncology and early-stage tumor removal, notwithstanding such restraints. Submucosal Injections Allow For Safe Tissue Elevation, Improved Visualization, And Decreased Perforation Risk, Clearly Making Them Essential For Therapeutic Endoscopy.
There is increasing demand for next-generation injectable solutions including hyaluronic acid blends, thermo-sensitive hydrogels, and viscoelastic polymer formulations, which offer improved mucosal lift and longer lasting elevation.
Integration of submucosal injection devices in robotic-assisted and AI-guided endoscopic systems also drives growth, laying the groundwork for more accurate, repeatable interventions. Investments on ergonomic injector designs, adjustable pressure settings, biocompatible filler technologies will gain a competitive edge for manufacturers.
In the Asia-Pacific region, increased uptake of submucosal injections was observed between 2020 and 2024 due to the rise in endoscopic resection procedures for early GI cancers. But cost constraints, a shortage of trained personnel and limited insurance coverage hampered wider adoption in developing economies. The majority of injectables during this time were based on saline and low-viscosity gel alternatives, leading to fleeting mucosal prominence.
The shift will be towards high retention-long period injectable agents and multipurpose injection systems that combine marking-staining-lifting. The role of submucosal injections in scar-free endoscopic surgery, obesity treatment and regenerative mucosal therapies will grow. The market will also benefit from the training programs, virtual endoscopy simulations, and telementoring for complex procedures.
Market Shifts: A Comparative Analysis 2020 to 2024 vs. 2025 to 2035
| Market Shift | 2020 to 2024 Trends |
|---|---|
| Regulatory Landscape | Approval of basic viscous injectables and reusable injection needles |
| Consumer Trends | Adoption driven by GI oncologists and advanced endoscopists |
| Industry Adoption | Focus on gastric and colorectal lesion removal procedures |
| Supply Chain and Sourcing | Reliance on saline, hydroxypropyl methylcellulose (HPMC), and dyed gels |
| Market Competition | Led by endoscopy tool manufacturers and surgical consumable suppliers |
| Market Growth Drivers | Increase in early cancer screening and minimally invasive GI therapies |
| Sustainability and Environmental Impact | Limited reuse of injector tools |
| Integration of Smart Technologies | Manual injector systems with visual tracking |
| Advancements in Injection Fluids | Standard gel formulations for short procedures |
| Market Shift | 2025 to 2035 Projections |
|---|---|
| Regulatory Landscape | Regulatory support for drug-device combination injectables and long-acting hydrogel agents |
| Consumer Trends | Expansion into general hospitals, outpatient centers, and robotic surgery settings |
| Industry Adoption | Growth in obesity endo therapy, GERD, and subepithelial tumor management |
| Supply Chain and Sourcing | Transition to multi-component, drug-loaded, and pH-responsive injectable materials |
| Market Competition | Entry of biotech firms, smart injector device startups, and regenerative therapy companies |
| Market Growth Drivers | Accelerated by AI navigation, high-precision injectors, and personalized endoscopic procedures |
| Sustainability and Environmental Impact | Move toward eco-friendly injectors, recyclable fluid cartridges, and waste-minimizing kits |
| Integration of Smart Technologies | AI-guided injection depth control, robotic-assisted elevation, and smart viscosity monitoring |
| Advancements in Injection Fluids | Innovation in hydrogels, nano-formulated injectables, and thermo-responsive tissue expanders |
United States with increasing use of injection for submucosal techniques in resection of colorectal polyps, treatment of Barrett's esophagus, and advanced therapeutic endoscopy. High rates of adoption owing to top-tier academic centers and procedural reimbursement frameworks. Biodegradable injectables and drug-releasing submucosal agents are also under R&D.
| Country | CAGR (2025 to 2035) |
|---|---|
| USA | 5.7% |
NHS-led cancer screen programs and upgrades to endoscopy services are driving increased use of submucosal injection techniques in the UK Diverse simulated GI resection modules at training centers, and the increasing interest in durable elevation agents in endoscopic resection.
| Country | CAGR (2025 to 2035) |
|---|---|
| UK | 5.5% |
Germany, France and Italy are leading EU adoption with strong demand for colorectal cancer resection and esophageal therapy High-viscosity and drug-combined injectables-clinical trials and real-word use in hospitals are encouraged by regulatory support.
| Region | CAGR (2025 to 2035) |
|---|---|
| European Union | 5.6% |
Japan is the birthplace of widespread submucosal injections use in ESD practice, and the country is still a global center for endoscopic innovation. With the expanding use of gastric and esophageal neoplasia resection, the country leads in the field of hydrogel-based injectables and electrosurgical-compatible needle systems.
| Country | CAGR (2025 to 2035) |
|---|---|
| Japan | 5.6% |
The demand for Advanced submucosal injection systems is supported by the robust gastrointestinal diagnostics and early cancer detection infrastructure in the country. Clinical adoption is accelerating in ambulatory endoscopy units, underpinned by tele-endoscopy tools and device innovation propelled by local enterprises.
| Country | CAGR (2025 to 2035) |
|---|---|
| South Korea | 5.7% |
As more healthcare providers adopt GI endoscopy procedures for the diagnosis or treatment of early-stage cancers, the market for submucosal injections is also growing steadily. Submucosal injection agents provide a fluid cushion under mucosal lesions, allowing EMR or ESD to be undertaken with lower risk of perforation.
Currently, the global market share of the agents is dominated by Eleview and ORISE gel® products while they are mostly applied to treat colorectal cancer. These segments allow for better visualization, mucosal lift and working space, and procedural control to guarantee safe, effective lesion removal with enhanced recovery results.
As general colorectal screening programs become widely adopted & minimal invasive, endoscopic techniques become integrated for early tumor resection, the need for novel specialized, biocompatible & long-acting submucosal agents that surpasses traditional saline solutions as therapy continues to progress.
| Type of Agent | Market Share (2025) |
|---|---|
| Eleview and ORISE gel® | 67.3% |
Eleview and ORISE gel® are second-generation submucosal injections that provide prolonged mucosal elevation, improved lesion visualisation and better resection control. They are composed of high molecular weight polymers and surfactants that synthesize a long-term submucosal cushion and therefore reduce the need for repeated injections during EMR/ESD.
These agents are favored by endoscopists for their viscosity, dye-enhanced visibility, and reduced risk of tissue damage. Unlike normal saline, they also lead to shorter procedure times and improved en bloc resection completeness.
These agents are frequently utilized in high-volume hospital and GI centers' endoscopy units to improve efficiency and reduce unwanted events, including bleeding or perforation. Ele view and ORISE gel® similarly contribute to cost-benefit outcomes by reducing procedure duration and improving clinical success rates.
Although normal saline is still used because it is cheap and set up in many resource-poor settings, Ele view and ORISE gel® are currently the leaders because their better clinical performance and further availability in major healthcare markets.
| Application | Market Share (2025) |
|---|---|
| Colorectal Cancer | 64.8% |
Due to the increasing level of global colorectal screening, polypectomies, and treatment of early-stage tumors, the indications for submucosal injections are dominated by colorectal cancer. During colonoscopy-based EMR and ESD, submucosal injections are commonly performed to lift suspicious lesions for safe and complete removal.
This approach avoids being invasive, requires no open surgery and provides faster recovery all of which make it the standard of care in many advanced health systems. Growing adoption of fecal immunochemical testing (FIT), high-definition colonoscopes, and AI-assisted lesion detection also strengthens procedural demand.
For patients with hereditary colorectal cancer syndromes or high-risk adenomas, colorectal cancer prevention programs have increasingly focused on polypectomy and endoscopic resection. Agents for submucosal injection are useful for enhancing resection margins and preventing complications. Gastric cancer applications are increasing presumably in East-Asian countries where ESD is being actively adopted, although colorectal cancer remains the dominant application, likely due to higher rates of screening globally and greater procedural volume.
High Demand in Gastrointestinal Endoscopy to Drive Submucosal Injections Balloons Market Growth. The submucosal injections market is gaining good momentum due to increased demand across gastrointestinal endoscopy, oncology interventions, and bariatric endoscopic procedures.
The increase in resections of early-stage cancers, endoscopic mucosal dissection (ESD) and treatments of gastrointestinal stromal tumors (GISTs) are fueling innovation in injection agents with greater lifting capacity, biocompatibility and procedural visibility.
Pharmaceutical firms are pouring investment into hyaluronic acid-based gels, synthetic polymer formulations, and prefilled syringes. Medical device companies and GI focused injectable developers have continually prioritized long duration cushion formation, ease of injection and mucosal safety.
Market Share Analysis by Key Players & Submucosal Injections Solution Providers
| Company Name | Estimated Market Share (%) |
|---|---|
| Boston Scientific Corporation | 14-18% |
| Olympus Corporation | 12-16% |
| GI Supply, Inc. (Steris) | 10-14% |
| Cosmo Pharmaceuticals N.V. | 8-12% |
| ERBE Elektromedizin GmbH | 6-9% |
| Other Submucosal Injection Providers | 30-40% |
| Company Name | Key Offerings/Activities |
|---|---|
| Boston Scientific Corporation | In 2024, expanded availability of ORISE® Gel for ESD and EMR with improved cushion durability; in 2025, introduced preloaded injection systems to reduce procedure time and contamination risk. |
| Olympus Corporation | Released LiftUp® hydrogel in 2024 for long-duration submucosal elevation during complex resections; in 2025, launched an integrated injection needle + gel cartridge system for single-use endoscopes. |
| GI Supply, Inc. (Steris) | Updated EverLift® agent in 2024 with enhanced visualization dye for lesion margins; in 2025, introduced larger volume delivery systems for colon EMR procedures. |
| Cosmo Pharmaceuticals N.V. | Launched GI Genius®-compatible Lift Agent & trade; in 2024 with AI-based targeting guidance; in 2025, began trials on a slow-resorbing injectable for post-resection mucosal healing support. |
| ERBE Elektromedizin GmbH | In 2024, bundled hybrid ESD-capable injection units with VIO electrosurgery platforms; in 2025, added dual-chamber delivery option for precision-mixed lifting agents and hemostatic additives. |
Key Market Insights
Boston Scientific Corporation (14-18%)
Boston Scientific maintains leadership in submucosal lifting with its ORISE® Gel platform. Its 2024 to 2025 advances in packaging and prefilled systems streamline GI workflows while improving procedural safety.
Olympus Corporation (12-16%)
Olympus is expanding in submucosal injection via LiftUp® integration with advanced endoscopy systems. The 2025 cartridge launch supports infection control and high-precision lesion access in single-use environments.
GI Supply, Inc. (Steris) (10-14%)
GI Supply’s EverLift® remains a trusted agent for EMR. Its 2025 high-volume solutions address large polyp resections while improving visualization for complete removal.
Cosmo Pharmaceuticals N.V. (8-12%)
Cosmo is introducing digital precision into the injection space. Its AI-guided Lift Agent & trade; and 2025 post-procedure mucosal therapies signal a dual approach to resection and recovery.
ERBE Elektro medizin GmbH (6-9%)
ERBE links injection performance with electrosurgical integration. The 2025 dual-chamber delivery systems enable multifunctional resection strategies in advanced therapeutic endoscopy.
Other Key Players (30-40% Combined)
A growing field of medical device firms and endoscopy solution providers is contributing to submucosal injection innovation for diverse GI applications. These include:
The overall market size for the submucosal injections market was USD 2,574.5 Million in 2025.
The submucosal injections market is expected to reach USD 4,439.5 Million in 2035.
The demand for submucosal injections is rising due to the increasing prevalence of colorectal cancer, growing adoption of minimally invasive endoscopic procedures, and the effectiveness of agents like Eleview and ORISE gel® in lesion removal. Advancements in gastrointestinal diagnostics and early cancer detection are further accelerating market growth.
The top 5 countries driving the development of the submucosal injections market are the USA, Germany, Japan, China, and the UK.
Eleview and ORISE gel® agents and colorectal cancer applications are expected to command a significant share over the assessment period.
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Submucosal Injections Market
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