Japan Biosurgery Market Overview, 2031

Key Insights

• The Japan biosurgery market represents one of the largest and most technologically advanced national markets for surgical biomaterials in Asia-Pacific. The market encompasses a broad range of biologically derived and bio-compatible materials including hemostatic agents, surgical sealants and adhesives, bone-graft substitutes, adhesion barriers, soft-tissue attachments, and staple-line reinforcement products that assist in surgical procedures by controlling bleeding, sealing tissues, promoting regeneration, and preventing postoperative complications.
• The Japan biosurgery market is distinguished by its universal healthcare system, world-class clinical infrastructure, and immense surgical volumes. According to the Japan Surgical Society's National Clinical Database (NCD), which now covers over 95% of surgeries performed nationwide with more than 20 million cumulative cases from over 5,800 institutions, Japan maintains one of the most comprehensive surgical data collection systems globally. In 2024, the NCD recorded 898,643 gastroenterological and abdominal surgical procedures and 151,470 cardiovascular surgical procedures. Healthcare expenditure in Japan reached approximately 11.68% of GDP in 2025, ranking 12th globally, reflecting the country's substantial commitment to healthcare. The market is shaped by a complex interplay of demographic trends, technological innovation, regulatory frameworks, and evolving healthcare delivery models.
• Bone-Graft Substitutes represent the largest product category within the Japanese biosurgery market, driven by the high volume of orthopedic and spinal procedures. Japan's aging population continues to drive demand for musculoskeletal interventions requiring bone-graft substitutes. Surgical Sealants and Adhesives represent the fastest-growing product category, driven by increasing adoption of minimally invasive surgical techniques. The NCD data shows significant growth in laparoscopic and thoracoscopic procedures, including 120,625 laparoscopic cholecystectomies in 2024.
• Japan's aging population represents the most significant long-term demand driver. As of 2025, 36.19 million people (29.4% of the population) were aged 65 years or older, the highest proportion among all countries with populations exceeding 40 million. The regulatory environment, centered on the Pharmaceuticals and Medical Devices Agency (PMDA) and the Ministry of Health, Labour and Welfare (MHLW), plays a decisive role in shaping market dynamics. The PMD Act was significantly amended on May 14, 2025, introducing major revisions for the first time in six years.
Market Outlook
• According to the research report, "Japan Biosurgery Market Overview, 2031 Overview, 2031," published by Bonafide Research, the Japan Biosurgery market is anticipated to add to more than USD 351.48 Million by 2026–31.The Japanese biosurgery market is expected to maintain steady growth through 2031, supported by favorable demographic trends, ongoing technological innovation, and expanding surgical volumes across both public hospitals and private clinics. The market's growth trajectory is intrinsically linked to the broader Japanese healthcare landscape, including healthcare expenditure, technological adoption, and demographic shifts.
• Japan's healthcare expenditure continues to rise, reaching approximately 11.68% of GDP in 2025, ranking 12th globally. This substantial healthcare investment provides the financial foundation for sustained surgical activity and biosurgical product utilization. The aging Japanese population represents the most significant long-term demand driver. As of 2025, 36.19 million people (29.4% of the population) were aged 65 years or older, the highest proportion globally. The Ministry of Health, Labour and Welfare projects that by 2040, 65+ population will account for approximately 35% of the total population.
• Technological innovation in biomaterials and surgical delivery systems is expanding the addressable market. The NCD data shows steady growth in minimally invasive procedures, including thoracoscopic surgeries, which recorded 114,938 procedures in 2024. The 2025 amendments to the PMD Act aim to ensure and promote access to pharmaceuticals and other medicinal products. Rising surgical procedures are a key driver propelling market expansion. The NCD now covers more than 95% of surgeries performed in Japan. The continued expansion of surgical capacity and the adoption of advanced techniques, including robotic-assisted surgery, will drive sustained demand for biosurgical products across all categories.

Market Dynamics
Driver: High Surgical Volumes and Comprehensive Surgical Data Infrastructure Japan performs hundreds of thousands of surgical procedures annually across its extensive network of hospitals and healthcare facilities. According to the Japan Surgical Society's National Clinical Database (NCD), which covers over 95% of surgeries nationwide with more than 20 million cumulative cases from over 5,800 institutions, 2024 recorded 898,643 gastroenterological and abdominal surgical procedures and 151,470 cardiovascular surgical procedures. The breadth and depth of surgical activity in Japan ensure that biosurgical products particularly hemostatic agents and sealants are utilized in virtually every operating room. Healthcare expenditure of 11.68% of GDP provides substantial financial resources to support expanding surgical volumes. The continued expansion of surgical capacity, driven by hospital modernization and the growing adoption of minimally invasive techniques, further reinforces this demand driver.



Challenge: Surgical Workforce Constraints and Aging Physician Population Despite the market's size and sophistication, Japan faces significant workforce challenges that could impact surgical capacity. The Japan Surgical Society reports that the number of board-certified surgeons stands at 21,863, with 40,912 doctors as members. However, concerns persist regarding surgeon shortages, with projections indicating a potential shortfall of approximately 5,000 gastrointestinal surgeons by 2040. The number of surgical residents has been a concern, with 863 surgical residents in 2025. These workforce constraints could limit surgical volume growth and, consequently, biosurgical product demand. Additionally, the healthcare system faces pressures from an aging population and rising healthcare costs, with total health expenditure in Japan having risen steadily from 7.03% of GDP in 2000 to 11.68% in 2025.

Trend: Accelerating Adoption of Minimally Invasive and Robotic-Assisted Surgery The Japanese biosurgery market is experiencing a significant trend toward minimally invasive and robotic-assisted surgical techniques. The NCD data reveals substantial growth in laparoscopic and thoracoscopic procedures. In 2024, 120,625 laparoscopic cholecystectomies were recorded, along with 87,819 laparoscopic inguinal hernia repairs and 25,233 thoracoscopic lobectomies with lymph node dissection for malignant lung tumors. Thoracoscopic surgeries have shown steady growth since 2021, with 114,938 procedures recorded in 2024. This shift toward advanced surgical platforms creates new opportunities for biosurgical products specifically designed for minimally invasive and robotic applications. Surgical sealants and adhesives that can be delivered through small incisions, hemostatic agents optimized for sprayable application, and staple-line reinforcement products compatible with minimally invasive staplers are increasingly in demand.

Policies

• The Pharmaceuticals and Medical Devices Act (PMD Act) serves as the primary regulatory framework for medical devices in Japan. On May 14, 2025, the PMD Act was significantly amended for the first time in six years, introducing major revisions.
• The Pharmaceuticals and Medical Devices Agency (PMDA) serves as the competent authority for medical device review and approval in Japan. PMDA conducts product reviews and ensures safety, efficacy, and quality of medical devices before they reach the market.
• Medical devices in Japan are classified into four risk categories under the PMD Act: Class I (general medical devices), Class II (controlled medical devices), Class III, and Class IV (highest risk), with corresponding regulatory pathways.
• The 2025 PMD Act amendments strengthen quality assurance and safety measures for pharmaceuticals and medical devices, with full implementation expected by May 2027.
• Marketing Authorization Holder (MAH) system requires foreign manufacturers to appoint a MAH in Japan to obtain and maintain product approvals. The 2025 amendments reinforce the quality assurance and safety control framework for MAHs.
• National Clinical Database (NCD) , established by the Japan Surgical Society in 2011, now covers over 95% of surgeries performed in Japan, serving as an essential platform for surgical quality assessment and board certification.

Segment Analysis

Japan Biosurgery Market By Product
• Bone-Graft Substitutes represent the largest product category within the Japanese biosurgery market, driven by the high volume of orthopedic and spinal procedures. Japan's aging population with 29.4% aged 65 and older continues to drive demand for musculoskeletal interventions. These products include demineralized bone matrix (DBM), synthetic bone grafts, and biologic grafts incorporating growth factors, widely utilized in joint replacement and spinal fusion procedures.
• Hemostatic Agents constitute a major market segment, reflecting their essential role across all surgical disciplines. These products including topical hemostats, flowable matrices, fibrin sealants, and thrombin-based agents are utilized in virtually every surgical procedure to control intraoperative bleeding. The comprehensive surgical volume captured by the NCD, covering over 95% of surgeries, underscores the substantial demand for hemostatic products.
• Surgical Sealants and Adhesives represent the fastest-growing product category in the Japanese biosurgery market, driven by increasing adoption of minimally invasive surgical techniques. These products including fibrin sealants, synthetic polymer-based sealants, and protein-based adhesives are used to seal tissue surfaces, prevent fluid and air leaks, and reinforce surgical anastomoses. The growth in laparoscopic and thoracoscopic procedures, with 120,625 laparoscopic cholecystectomies in 2024, supports the expansion of this segment.
• Adhesion Barriers represent a clinically important product category used to prevent postoperative adhesion formation in abdominal, pelvic, and gynecological surgeries. The category continues to benefit from ongoing product innovation and clinical evidence supporting adhesion prevention, particularly as the volume of gynecological and abdominal procedures remains substantial.
• Soft-Tissue Attachments encompass products used to reinforce, repair, or secure soft tissues, including surgical meshes, biologic scaffolds, and tissue grafts. These products are utilized in hernia repair, pelvic floor reconstruction, and various other soft-tissue procedures. Inguinal hernia repairs, both laparoscopic (87,819) and open (59,483), represent significant volumes.
• Staple-Line Reinforcement products are utilized in gastrointestinal, bariatric, and thoracic procedures to strengthen tissue interfaces along surgical staple lines, reducing the risk of bleeding and leakage. The increasing volume of thoracic and gastrointestinal procedures, including 25,233 thoracoscopic lobectomies, supports steady demand for these products.

Japan Biosurgery Market By Application
• Orthopedic Surgery is the largest application area for biosurgical products in Japan, driven by the high volume of joint replacement, spinal fusion, and trauma procedures. The aging Japanese population with 29.4% aged 65 and older continues to drive demand for musculoskeletal interventions. Bone-graft substitutes are the primary biosurgical products utilized in this specialty.
• General Surgery encompasses a broad range of abdominal, gastrointestinal, and soft-tissue procedures. The NCD recorded 898,643 gastroenterological and abdominal surgical procedures in 2024. Biosurgical products utilized include hemostatic agents, surgical sealants, staple-line reinforcement products, and adhesion barriers. Laparoscopic cholecystectomy (120,625) and inguinal hernia repairs represent significant volumes.
• Cardiovascular Surgery represents the fastest-growing application area in the Japanese biosurgery market, driven by the high prevalence of cardiovascular disease and the aging population. The NCD recorded 151,470 cardiovascular surgical procedures in 2024. The Japanese Association for Thoracic Surgery reported 64,047 cardiovascular surgeries in 2024. Vascular sealants, hemostatic agents, and soft-tissue attachments are increasingly utilized.
• Neurological Surgery utilizes biosurgical products particularly hemostatic agents and dural sealants to manage bleeding and prevent cerebrospinal fluid leaks in cranial and spinal procedures. The aging population and increasing incidence of neurological conditions drive demand in this specialty. The NCD data for neurosurgical procedures is collected through the comprehensive database covering over 95% of surgeries.
• Reconstructive Surgery involves the use of biosurgical products to restore, repair, or reconstruct damaged or surgically altered tissues, including soft-tissue repair, tissue reinforcement, and wound reconstruction following injury, disease, or surgery.
• Gynecological Surgery includes biosurgical applications in procedures involving the female reproductive system, with products used for hemostasis, tissue sealing, adhesion prevention, tissue repair, and reinforcement.
• Urological Surgery covers biosurgical applications in procedures involving the urinary tract and male reproductive system, with products used for bleeding control, tissue sealing, reinforcement, repair, and prevention of postoperative complications. The NCD Urology Division reports on five key urological procedures, including partial nephrectomy, radical nephrectomy, radical cystectomy, radical prostatectomy, and pyeloplasty.
• Thoracic and Other Surgeries represent a growing application area, driven by increasing adoption of video-assisted thoracoscopic surgery (VATS). The NCD recorded 114,938 thoracic surgical procedures in 2024, with steady growth since 2021. Thoracoscopic lobectomy with lymph node dissection for malignant lung tumors accounted for 25,233 procedures.

Japan Biosurgery Market By Source/Origin
• Biologic products represent the largest source category in the Japanese biosurgery market, driven by their superior biocompatibility and natural healing properties. These products include demineralized bone matrix, fibrin sealants, collagen hemostats, allografts, and xenografts. Japan's rigorous regulatory framework, overseen by the PMDA, ensures high safety standards for biological materials.
• Synthetic and Semi-Synthetic products represent the fastest-growing source category in the Japanese market, driven by cost-effectiveness, consistent quality, lower immunogenicity risks, and longer shelf life. These products include synthetic bone substitutes, PEG-based sealants, synthetic meshes, and polysaccharide hemostats. The 2025 PMD Act amendments aim to ensure and promote access to pharmaceuticals and medical products.

Japan Biosurgery Market By End-User
• Hospitals remain the largest end-user segment for biosurgical products in Japan, accounting for the majority of revenue. As of October 1, 2024, Japan had 8,060 hospitals. The concentration of complex surgical procedures and availability of specialized surgical teams make hospitals the primary setting for biosurgical product utilization. The NCD data, covering over 95% of surgeries from more than 5,800 institutions, reflects the dominance of hospital-based surgical care.
• Ambulatory Surgical Centers (ASCs) represent the fastest-growing end-user segment in the Japanese biosurgery market, driven by the broader healthcare industry shift toward outpatient and same-day discharge models. The expansion of outpatient surgical capacity supports the adoption of biosurgical products in these settings. General clinics increased by 539 facilities in 2024.
• Clinics represent a growing end-user segment, with specialty clinics performing eligible surgical or minimally invasive procedures utilizing biosurgical products for tissue repair, bleeding control, and sealing. As of 2024, Japan had approximately 99,792 clinics without beds . Clinics with beds decreased by 226 facilities.

Japan Biosurgery Market Economics

• Japan’s biosurgery market benefits from exceptionally high surgical volumes and comprehensive clinical data infrastructure. The Japan Surgical Society’s National Clinical Database (NCD) covers more than 95% of surgeries, with over 20 million cumulative cases from 5,800+ institutions. In 2024, the database recorded 898,643 gastroenterological and abdominal procedures and 151,470 cardiovascular procedures, supporting widespread use of hemostatic agents, sealants, and tissue-repair products. Healthcare expenditure reached 11.68% of GDP in 2025, providing substantial resources for surgical care. However, workforce constraints remain a challenge, with 21,863 board-certified surgeons and potential projections of a 5,000 gastrointestinal-surgeon shortfall by 2040.
• major market trend is the accelerating adoption of minimally invasive and robotic-assisted surgery. In 2024, Japan recorded 120,625 laparoscopic cholecystectomies, 87,819 laparoscopic inguinal hernia repairs, and 114,938 thoracic procedures, including 25,233 thoracoscopic lobectomies with lymph-node dissection. This transition creates demand for biosurgical products compatible with small-incision procedures, including sprayable hemostats, minimally invasive sealants, tissue adhesives, and staple-line reinforcement technologies. Bone-graft substitutes remain the largest product category, supported by Japan’s aging population, while hemostatic agents represent a major established segment. Surgical sealants and adhesives are among the fastest-growing categories due to minimally invasive surgery.
• Japan’s regulatory environment is governed by the Pharmaceuticals and Medical Devices Act (PMD Act), with the Pharmaceuticals and Medical Devices Agency (PMDA) responsible for product review and safety oversight. Devices are classified into four risk categories, with requirements increasing according to risk. Amendments to the PMD Act enacted in May 2025 strengthen quality assurance and safety controls, with full implementation expected by May 2027. Foreign manufacturers must appoint a Marketing Authorization Holder (MAH) in Japan. The NCD also plays an important role in surgical quality assessment and professional certification, providing manufacturers with an extensive evidence base for evaluating clinical outcomes and technology adoption.
• Hospitals remain the dominant end-user, with 8,060 hospitals recorded as of October 2024, while ambulatory surgical centers and clinics represent growing opportunities as outpatient care expands. General surgery is a major application area, while orthopedic surgery remains the largest application segment because of high joint replacement, spinal, and trauma volumes. Cardiovascular surgery is among the fastest-growing applications, with 151,470 NCD-recorded procedures in 2024. Biologic products currently represent the largest source category because of biocompatibility, while synthetic and semi-synthetic products are growing rapidly due to consistent quality, cost-effectiveness, lower immunogenicity, and longer shelf life. Overall, demographic aging, technological adoption, and extensive surgical infrastructure support sustained biosurgery demand.


Considered in this report
• Historic Year: 2020
• Base year: 2025
• Estimated year: 2026
• Forecast year: 2031

Aspects covered in this report
• Biosurgery Market with its value and forecast along with its segments
• Various drivers and challenges
• On-going trends and developments
• Top profiled companies
• Strategic recommendation

By Product
• Bone-Graft Substitutes
• Hemostatic Agents
• Surgical Sealants & Adhesives
• Adhesion Barriers
• Soft-Tissue Attachments
• Staple-Line Reinforcement

By Application:
• Orthopedic Surgery
• General Surgery
• Neurological Surgery
• Cardiovascular Surgery
• Reconstructive Surgery
• Gynecological Surgery
• Urological Surgery
• Other surgeries (Thoracic surgeries & more)

By Source/Origin
• Biologic
• Synthetic / Semi-synthetic

By End-user:
• Hospitals
• Ambulatory Surgical Centers
• Clinics
• Others