Authors:
Monali Tayade, Sampada Kulkarni
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U.S. Flexible Endoscopic Surgery Robot Market Size & Share 2026-2035
Report ID: GMI15183
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Published Date: September 2026
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U.S. Flexible Endoscopic Surgery Robot Market Size
The U.S. flexible endoscopic surgery robot market was valued at USD 609.8 million in 2025, is projected to reach USD 689.1 million in 2026, growing at a CAGR of 11.9% from 2025 to 2035 to reach USD 1.85 billion by 2035.
U.S. Flexible Endoscopic Surgery Robot Market Key Takeaways
Market Leader: Intuitive Surgical led with over 58% market share in 2025.
Leading Players: Top 3 players in this market include Intuitive Surgical, Johnson & Johnson, Noah Medical, which collectively held a market share of 89% in 2025.
The market is moving from initial platform adoption toward an installed-base model in which procedure utilization, instrument replenishment, and service relationships become increasingly important to revenue quality. FDA-cleared bronchoscopy platforms have established the commercial foundation, while emerging urology and gastrointestinal use cases broaden the addressable clinical workflow. Johnson & Johnson's MONARCH QUEST clearance illustrates the rising importance of integrated navigation and imaging capabilities in platform purchasing decisions [1]Johnson & Johnson. “Johnson & Johnson MedTech Announces Clearance of MONARCH™ QUEST for Enhanced Robotic-Assisted Bronchoscopy.” jnj.com. Noah Medical's Galaxy system has also expanded the set of commercially relevant robotic bronchoscopy platforms available to U.S. providers [2]Noah Medical. “Noah Medical's Galaxy System Surpasses 5,000 Procedures, Marking a New Era in Robotic-Assisted Bronchoscopy.” noahmed.com.
GMI Analyst View
Based on our primary research and cross-market engagement with U.S. healthcare procurement networks, the United States accounted for approximately 56% of the global flexible endoscopic surgery robot market in 2025. This concentration reflects the country's first-mover advantage in FDA-cleared robotic bronchoscopy and the scale of hospital robotics capital programs. We expect the U.S. installed base and recurring procedure economics to remain central to global market performance even as international markets develop additional commercial scale.
U.S. Flexible Endoscopic Surgery Robot Market Trends, Growth Drivers & GMI Forecast Outlook
Lung-nodule diagnostic demand, ambulatory care migration, and AI-enabled workflow differentiation are expanding the clinical case for flexible robotic platforms. However, capital-placement maturity, reimbursement uncertainty, and constrained operator availability will determine how quickly demand shifts beyond established academic bronchoscopy programs.
Key Drivers
*Evidence anchors use cited external data; demand implications and forecast conditions represent GMI analysis.*
Lung cancer screening changes the commercial logic of robotic bronchoscopy because it enlarges the pipeline of peripheral lesions requiring diagnostic assessment before treatment decisions can be made. The technology's value proposition rests on improving access to lesions that can be difficult to reach with conventional approaches, allowing interventional pulmonology programs to integrate navigation, visualization, and confirmation into a more standardized pathway. As screening cohorts expand, high-volume centers have greater incentive to protect scheduling capacity, procedural consistency, and referral-network confidence through robotic workflows.
The migration of suitable procedures toward ambulatory settings creates a separate growth path from hospital capital budgets. Compact systems, disposable bronchoscopes, and service models designed around procedural throughput could lower some of the operational barriers that have historically concentrated flexible robotics in interventional suites at large hospitals. Commercial expansion will nevertheless depend on whether payment pathways adequately recognize the equipment, staffing, and instrument costs associated with robotic endoscopy in outpatient care.
AI-enabled guidance is becoming a procurement differentiator rather than an adjunct feature. Platforms that combine procedural planning, real-time navigation, image integration, and post-case analytics can be more deeply embedded in institutional protocols and training pathways. That integration may favor suppliers able to support upgrades across hardware, software, clinical education, and workflow data, while increasing the burden on newer entrants to demonstrate comparable clinical and operational value.
Key Restraints
*Evidence anchors use cited external data; demand implications and forecast conditions represent GMI analysis.*
The deceleration in system placements signals a commercial transition rather than a loss of clinical relevance. Early-adopter hospitals have already made substantial investments in robotics programs, room integration, and physician education. As those accounts emphasize utilization and replacement planning, suppliers must compete for share within more disciplined capital cycles, while recurring consumable and service revenue becomes more consequential to platform economics.
Reimbursement remains particularly important for facilities with lower procedural scale and less capacity to absorb uncertain margins. Transitional payment mechanisms can support early market formation, but they do not provide the durable procedural economics needed for broad community and ambulatory adoption. Until coding and payment more consistently reflect the resource intensity of robotic endoscopy, many providers will limit use to high-priority cases or established referral programs.
Training is also a practical constraint on geographic diffusion. A system can be physically deployable in a community facility without that facility having the physician volume, multidisciplinary coordination, or support staff experience required to build a reliable robotic bronchoscopy program. Developer-led education, proctorship, and workflow standardization will therefore shape adoption as materially as hardware availability.
GMI Analyst View
We view the principal market tension as a divergence between clinical demand and the pace of capital conversion. Screening-driven diagnostic need continues to build, but commercial expansion beyond established centers depends on payment durability and outpatient workflow readiness. The next demand wave will be determined by whether ambulatory economics mature quickly enough to convert clinical interest into repeatable purchasing decisions.
U.S. Flexible Endoscopic Surgery Robot Market Segment Analysis
By Category
Therapeutic
Therapeutic applications generated USD 396.4 million in u.s. flexible endoscopic surgery robot market revenue in 2025 and are projected to account for approximately 70% of market revenue by 2035. Therapeutic procedures benefit from the economic value of recurring instrument use and from provider demand for controlled access, navigation, and intervention within increasingly complex endoluminal cases. Bronchoscopy remains the immediate commercial anchor, but gastrointestinal intervention could broaden the category as regulatory and reimbursement conditions evolve. The category's strategic importance lies in its ability to connect capital placement with repeat procedural consumption.
Diagnostic
Diagnostic applications represented 35% of market revenue in 2025 and are projected to generate USD 555 million by 2035. Diagnostic use remains essential because suspicious pulmonary lesions, urological disease pathways, and future gastrointestinal screening workflows all require reliable visualization and tissue-acquisition capabilities. The category's development is linked to clinical confidence in targeting accuracy, workflow reproducibility, and the ability of platforms to fit into existing diagnostic pathways without creating excessive procedural complexity.
By Application
Urology
Urology is projected to generate USD 647.5 million by 2035 and represented approximately 33% of market revenue in 2025. The U.S. urology opportunity is shaped by the prospect of dedicated robotic ureteroscopy platforms entering a market where conventional flexible ureteroscopy still dominates. J&J has indicated that Monarch Platform for Urology is planned for U.S. commercial availability in 2026, which could expand the competitive scope of flexible robotics beyond bronchoscopy [7]Medical Products Outsourcing. “Johnson & Johnson MedTech Expands Surgical Robotics Using NVIDIA AI.” mpo-mag.com. Adoption will depend on clinician training, procedural economics, and whether platforms demonstrate workflow advantages in high-volume stone and urinary-tract procedures.
Respiratory (Bronchoscopy)
Respiratory bronchoscopy represented 42% of market revenue in 2025 and is projected to generate USD 666 million by 2035. Respiratory bronchoscopy is the market's most commercially established application because it addresses a defined clinical need: obtaining samples from peripheral lung lesions identified through screening and imaging pathways. Robotic systems compete on navigation confidence, image integration, procedural efficiency, and the quality of the support ecosystem surrounding a bronchoscopy program. This application will remain central to market performance even as other endoluminal use cases gain traction.
Gastrointestinal
Gastrointestinal applications generated USD 121.9 million in 2025 and are projected to expand at a CAGR of 13.8% (2025-2035). Gastrointestinal robotics represents an important diversification pathway because it could extend flexible robotic systems into therapeutic procedures with substantial procedural volumes and demanding technical requirements. Commercial success will require more than regulatory clearance: developers must establish clinician value in complex resection and endoscopic intervention, integrate with gastroenterology workflows, and demonstrate a cost structure suitable for a broad provider base.
Other Applications
Other applications generated USD 30.5 million in 2025 and are projected to expand at a CAGR of 11.7% (2025-2035). This group includes early endoluminal robotics activity in areas such as ENT and pancreatobiliary care. Its role is less about near-term revenue concentration than about creating option value for platforms that can support adjacent procedures without requiring a wholly separate capital ecosystem. Clinical validation and specialist adoption will determine which of these niches develop into durable commercial markets.
By End Use
Hospitals & Clinics
Hospitals and clinics generated USD 426.9 million in revenue in 2025 and are projected to account for approximately 58% of market revenue by 2035. Hospitals and clinics remain the operational center of flexible robotic endoscopy because they possess the capital capacity, imaging infrastructure, referral networks, and multidisciplinary clinical teams needed for complex robotic programs. They will continue to anchor training, clinical evidence generation, and high-acuity cases even as more routine procedures migrate toward lower-cost sites of care.
Ambulatory Surgical Centers
Ambulatory surgical centers are projected to generate USD 684.5 million by 2035 and are expected to expand at a CAGR of 16.2% (2025-2035). ASCs offer the market's clearest route to broader site-of-care penetration, particularly for systems built around compact footprints and disposable components. The opportunity is contingent on payment alignment, case selection, and operational simplicity. Suppliers that can reduce room turnover burden and make robotic procedures viable without hospital-scale infrastructure will be better positioned to capture this transition.
Other End Use
Other end-use settings represented 5% of market revenue in 2025 and are projected to expand at a CAGR of 11.7% (2025-2035). Research institutions, military hospitals, and specialized facilities play a focused role in clinical protocol development, training, and early evaluation of emerging applications. Although this segment is comparatively small, it can influence future adoption by generating clinical familiarity and evidence before technologies move into mainstream hospital and ambulatory settings.
GMI Analyst View
We see the segment mix as commercially concentrated but not structurally static. Robotic bronchoscopy provides the current utilization base, while urology and gastrointestinal applications offer the most credible routes to diversification. The decisive issue is not merely technical readiness; it is whether clinical, regulatory, and payment conditions align quickly enough to support adoption outside the market's established bronchoscopy ecosystem.
U.S. Flexible Endoscopic Surgery Robot Market Regional Analysis
United States
The Flexible Endoscopic Surgery Robot Market in the U.S. is concentrated initially in academic medical centers, oncology networks, and high-volume referral hospitals that can support advanced imaging, interventional pulmonology expertise, and structured robotic training. These providers are well positioned to integrate robotic bronchoscopy into lung-nodule diagnostic pathways and to use platform data, procedural protocols, and service support across a growing installed base.
The market's longer-term geographic opportunity lies in extending access beyond established metropolitan referral centers. Lung cancer burden is substantial in many communities where advanced bronchoscopy infrastructure is less developed, making portable designs, repeatable training models, and reimbursement certainty important prerequisites for broader diffusion. The U.S. ambulatory infrastructure is material to this opportunity: 6,436 Medicare-certified ASCs operated in the United States in 2024 [4]Medicare Payment Advisory Commission. “Ambulatory Surgical Center Services: Chapter 11 — Report to the Congress: Medicare Payment Policy.” medpac.gov, serving approximately 3.4 million fee-for-service beneficiaries and providing an extensive foundation for outpatient care migration where payment and clinical workflows permit [4]Medicare Payment Advisory Commission. “Ambulatory Surgical Center Services: Chapter 11 — Report to the Congress: Medicare Payment Policy.” medpac.gov.
GMI Analyst View
We believe the most consequential geographic issue is the gap between concentrated robotic capacity and dispersed clinical need. Metropolitan academic systems will remain the initial commercial core, but community expansion represents the market's larger strategic prize. Suppliers that pair practical training pathways with outpatient-ready technology and credible economic support will have the strongest opportunity to move beyond referral-center dependence.
U.S. Flexible Endoscopic Surgery Robot Market Share & Competitive Landscape
The U.S. flexible endoscopic surgery robot market share structure is concentrated around established robotic bronchoscopy platforms, with competitive advantage determined by installed-base depth, clinical training capability, navigation performance, instrument economics, and the ability to support provider workflow. Competitive intensity is increasing as newer platforms seek to challenge incumbents with compact designs, disposable components, and differentiated imaging or guidance capabilities.
Intuitive Surgical (Ion)
Intuitive Surgical held approximately 58% of U.S. market revenue in 2025.
Ion benefits from Intuitive Surgical's established commercial infrastructure, training resources, and hospital relationships. The platform's competitive position is increasingly tied to the productivity of its installed base rather than only to new placements. Intuitive Surgical reported growth in worldwide Ion procedures during 2025, reinforcing the importance of procedure utilization and recurring consumables as the platform matures [5]Intuitive Surgical. “Intuitive Announces Preliminary Fourth Quarter and Full Year 2025 Results.” isrg.intuitive.com.
J&J / Auris Health (Monarch)
J&J / Auris Health held approximately 24% of U.S. market revenue in 2025. Monarch is the principal incumbent alternative to Ion in robotic bronchoscopy and is positioned around integrated navigation, imaging, and workflow capabilities. The MONARCH QUEST upgrade strengthens J&J's ability to compete on AI-enabled procedure planning and intraprocedural confirmation. Its planned extension into urology could also create a broader application portfolio than single-indication bronchoscopy competitors can offer.
Noah Medical (Galaxy)
Noah Medical held approximately 7% of U.S. market revenue in 2025. Galaxy is positioned as a growth-oriented alternative for providers seeking a compact robotic bronchoscopy system with disposable bronchoscopes and imaging-guidance features. Its commercial opportunity is closely tied to the ability to reduce deployment complexity in facilities outside traditional interventional operating rooms. The platform's challenge is to translate early procedural momentum into durable account expansion while competing against incumbent training networks and installed-base relationships.
Avicenna
Avicenna's Roboflex is a CE-marked robotic ureteroscopy platform with relevance to the longer-term development of U.S. robotic urology. It does not have a material U.S. commercial revenue presence in the base year because it lacks FDA clearance. Nevertheless, the platform illustrates how dedicated ureteroscopy systems could alter the application mix and competitive structure if comparable technologies achieve U.S. market access.
Recent Industry Developments
Johnson & Johnson MedTech received FDA 510(k) clearance for MONARCH QUEST in March 2025. The upgrade incorporates AI-guided navigation, CBCT integration, and a connected workflow spanning planning through post-case review, raising the competitive standard for robotic bronchoscopy platforms [1]Johnson & Johnson. “Johnson & Johnson MedTech Announces Clearance of MONARCH™ QUEST for Enhanced Robotic-Assisted Bronchoscopy.” jnj.com.
Noah Medical announced in March 2025 that its Galaxy system had surpassed 5,000 U.S. procedures. The milestone indicates growing commercial use of an alternative platform built around disposable bronchoscopy and imaging-supported navigation [2]Noah Medical. “Noah Medical's Galaxy System Surpasses 5,000 Procedures, Marking a New Era in Robotic-Assisted Bronchoscopy.” noahmed.com.
J&J MedTech announced in October 2025 that its Monarch Platform for Urology is expected to become commercially available in the United States in 2026. The planned launch would introduce an established robotics supplier into a domestic application area that remains less developed than robotic bronchoscopy [7]Medical Products Outsourcing. “Johnson & Johnson MedTech Expands Surgical Robotics Using NVIDIA AI.” mpo-mag.com.
Intuitive Surgical reported preliminary full-year 2025 results in January 2026 that highlighted a maturing Ion business characterized by stronger procedure activity alongside moderated system-placement momentum [5]Intuitive Surgical. “Intuitive Announces Preliminary Fourth Quarter and Full Year 2025 Results.” isrg.intuitive.com.
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