Features of ESD

01

Competitive productdevelopment

Market scale and growth forecast of
GI Endoscopy

GI Endoscopy¥300 – 400 billion● From the time when Olympus developed theESDs first practical gastrocamera in 1950
world ’
to today, Olympus has continued to refine its
endoscope technologies in close
collaboration with physicians● Developing technologies that contribute to
the improvement of the quality of endoscopy
around the world, such as NBI, RDI, TXI, and
EDOF● Providing high-definition and high-quality
products with 4K/3D technology● Acquisition of advanced fluorescence imaging
technology and promotion of research anddevelopment toward next-generation
molecular imaging technology

In its Endoscopic Solutions Business, Olympus uses innovative capabilities inmedical technology, therapeutic intervention and precision manufacturing to help

Market Share

No.1

Approx. 55% of
ESD revenue
Note: Served market scale and growth forecast information for this page comefrom the Company’s research and pertains to data for the U.S., EU5(Germany, UK, Italy, France, Spain), Japan and China, Market scale is asof March 31, 2023, Growth forecasts are projected for fiscal year 2023 to
fiscal year 2026. The Sub-segment sales ratio within ESD is a figure of
fiscal year 2023.

02
Endoscopic Solutions DivisionMarket CAGR 4 – 6%

Solid business foundations

1 Global service
network

2 Support training
endoscopists

3 Craftsmanship for
meeting physician
needs

Established a global network ofservice locations: Europe, theAmericas, Middle East, Africa,
Japan, China, and Asia, which is
the largest network of service sites
for any global medical device
manufacturer

Supporting training for endoscopists
by opening training centers in China
and other Asian countries, where
demand for early diagnosis andminimally invasive treatment is
expanding along with the economic
growthProviding more than 300 types ofendoscopes through advanced
manufacturing technology andhigh-mix, low-volume production tomeet diversifying customer needs

Large endoscope repair center

Olympus China Medical Training &Education Center Shanghai(C-TEC Shanghai)

Endoscope

healthcare professionals deliver diagnostic, therapeutic and minimally invasive
procedures to improve clinical outcomes, reduce overall costs and enhance thequality of life for patients and their safety. Starting with the world s firstgastrocamera in 1950, Olympus Endoscopic Solutions portfolio has grown to
include endoscopes, laparoscopes, video imaging systems, as well as system
integration solutions and medical services.

10

11

01

Competitive product development

GI Endoscopy

Innovative Imaging Technologies

Past

In 2020, we launched the EVIS X1, the latest model of our endoscopy system. As of February 2024, thesystem is marketed in Japan, U.S., Europe, China and parts of Asia. This model is equipped with thefollowing three imaging technologies that will further improve treatment and diagnosis. It contributes to early
detection, early diagnosis, and minimally invasive treatment of gastrointestinal diseases such as cancer.

The Birth and Spread of Gastrocamera
At the department of surgery, the University of Tokyo Branch Hospital, with the support ofAssistant Professor Takeo Hayashida, Dr. Uji and the Olympus technical team developed
an experimental gastrocamera. This gastrocamera was launched in 1952 as the“GT-I
Gastrocamera.”However, as there were a number of problems with the early product andimaging techniques had not been well established, it did not catch on. Gastrocamera
operations ran a deficit, and there were discussions at Olympus as to whether thebusiness could continue on as it was. Amid this, the first place to recognize the potentialof the gastrocamera and make an effort to popularize it was in the #8 ResearchLaboratory of the University of Tokyo Main Hospital First Department of Internal Medicine(Tasaka Internal Medicine Department: Professor Sadataka Tasaka).
The Tasaka Internal Medicine Department first assisted Olympus by offering advice
regarding problems with this early instrumentation from a user's point of view. But thegreater topic at the time was the need to establish a standardized technique forphotographing the inside of the stomach. The gastrocamera differs from the fiberscope inthat the doctor cannot directly observe the inside of the stomach during the examination.
It is exceedingly difficult to get a satisfactory image while blindly maneuvering the
instrument around inside the stomach.
In order to determine the location of the gastrocamera in relation to the various partsof the stomach, various daunting tasks had to be repeated, such as using X-rays andrecording the gastrocamera's degree of insertion, twisting of the shaft and noting theresult, and measuring the amount of air flow required to optimally insufflate the stomach.
Through these experiments, a standardized imaging technique was established around1956.
The role of the“Gastrocamera Research Group”(currently the Japan
Gastroenterological Endoscopy Society), as first established and centered around theTasaka Internal Medicine Department, cannot be forgotten. The first meeting of the
Gastrocamera Research Group was held in 1955, and research reports focusing on
cancer were presented. At the fifth research society meeting in 1958, there were 16
presentations and 200 attendees, and research had progressed to the clinical stage.
Along with Olympus as the manufacturer, the group established the Technology
Committee (afterward the Gastrocamera Promotion Committee) in 1955. Once a month,they met to share opinions regarding failure prevention and device improvements. These
efforts became the driving force behind the spread of the gastrocamera.

EVIS X1TXI Texture and Color Enhancement Imaging
TXI supports better visibility of potential lesions (such as areas of inflammation, flat or depressed lesions, or even tiny
precursor lesions) through enhancing texture, brightness, and color to define subtle tissue differences more clearly. With its
advanced imaging technology, TXI holds the potential to reinvent white light in endoscopy. By supporting better visibility ofpotential and extant lesions, TXI aims to contribute to higher detection rates and improve qualitative diagnosis.

Normal lightobservation

First Gastrocamera Research Group meeting(at the podium, Professor Tasaka)

After TXIBaseBrightness enhancement/Correction

RDI Red Dichromatic Imaging

The gastrocamera, developed by Olympus in 1950, greatly influenced early-stage stomach cancer diagnostics. Through theaccumulated research that followed, it was understood that early-stage lesions could be found through slight differences in the color of
mucosal surfaces within the digestive tract. A technique called“chromoendoscopy,”spread rapidly starting in the 1970’
s. Thisprocedure sprays various dyes on the tissue lining the GI tract in order to detect subtle lesions that are hard to detect using normal
endoscopic imaging. Olympus expanded upon these principles and developed a technique called Narrow Band Imaging (NBI) that isdesigned to reveal subtle lesions through an optical method. NBI is one example of an imaging enhancement technique that uses a
combination of optical and digital methods (opto-digital).

12

Color tone enhancement

Synthesized

Separated

Image-enhanced Endoscopy and NBI① Blue light : Strongly absorbed by hemoglobin in capillaries

near the tissue surface, and not reflected.

② Blue light : Strongly reflected by the mucosal surface layer.
③ Green light : Strongly absorbed by hemoglobin in bloodvessels deeper in the tissue, and not reflected.

④ Green light : Strongly reflected by the tissue beneaththe mucosa.

⑤ A well-resolved image is produced by utilizing both reflected

and non-reflected

Monitor screen in NBI mode
Capillary in mucosal
surface layer
Larger blood vesselin tissue below mucosa

Texture enhancement

Image processing
operation

Present

Narrow Band Imaging (NBI)
Olympus developed Narrow Band Imaging technology toenhance observation of mucosal tissue. NBI is an opticalimaging technology that enhances the visibility of vessels andother tissue on the mucosal surface. NBI works by filtering thewhite light into specific light wavelengths that are absorbed byhemoglobin and penetrate only the surface of human tissue.
As a result, with Narrow Band Imaging, capillaries on themucosal surface are displayed in brown and veins in the
submucosa are displayed in cyan on the monitor.

TextureDr. Uji (center), attending a clinical trial

Brown : Capillary in mucosal surface layer
Blue : Larger blood vessel in tissue below
mucosaGastrointestinal bleeding is a serious challenge, potentially involving
considerable mortality risks and management costs. RDI enhances
the visibility of deep blood vessels and gastrointestinal bleeding
sources, thereby helping to identify blood vessels that could require
immediate treatment. It utilizes green, amber, and red wavelengths tovisualize deep blood vessels. Easier identification of bleeding spots
makes hemostasis quicker and easier while potentially improving theefficiency of any corresponding treatment. This minimally invasive
technology could also be expected to help reduce physician stressduring endoscopic therapy.

EDOF Extended Depth of Field
EDOF combines two images at different focus distances into one
perfect image to help aid diagnosis and confidant decision-making. It
delivers observational excellence through continuous broad focus andseamless magnification. At the same time, the established Dual Focus
function provides high magnification, which can be activated by thepush of a button. This improved visibility and continuously sharp
image has been developed to reduce the necessity for focal
adjustments and could be expected to improve efficiency anddecrease the oversight rate.

Dual Focus

Reflector 1 Reflector 2
EDOF

Beam splitter

Image sensor
Forms two different
images simultaneously

13

02

Solid business foundations

1 Global service network

Surgical Endoscopy
4K, 3D, and Infra-Red Imaging
We established Sony Olympus Medical Solutions Inc., a joint venture with Sony
Corporation, in 2013. Sony Olympus Medical Solutions is engaged in the researchand development of new products that combine Sony's cutting-edge electronics
technologies in areas such as digital imaging with Olympus' manufacturing and
R&D expertise in the area of medical products including lenses and opticaltechnologies.

Olympus Winter & Ibe GmbH (OSTE)
Germany(Hamburg)

Olympus Czech Group, s.r.o.
Regional Repair Centre
Czech(Prerov)

Olympus Europa SE & Co. KG
Medical Repair Service EMEA, Regional Repair Centre
Germany(Hamburg)

Olympus Moscow LLC
Russia(Moscow)

Olympus Korea Co., Ltd.
Korea(Incheon)

Gyrus ACMI, Inc. (OSTA National Service Center West)
United States of America(San Jose)

Olympus Medical Systems
India Private Limited
India(Gurgaon)

Shirakawa Olympus Co., Ltd.
Shirakawa Medical Equipment Service Operation Center

Gyrus ACMI, Inc. (OSTA National Service Center East)
United States of America(Bartlett)

Nagano Olympus Co., Ltd.
Nagano Medical Equipment Service Operation Center

Olympus Canada Inc.
Canada(Toronto)● Surgical Endoscopy System that Supports 4K, 3D andInfrared (IR) Imaging Features
Olympus launched VISERA ELITE III in 2022. Not only does the system enable useof 4K, 3D, infra-red (IR) imaging, NBI observation modes, and further options tomeet surgeons’needs, it is also compatible with Olympus’existing rigid scopes,
flexible scopes, and camera heads. Furthermore, the system software can be
upgraded allowing for additional functions, and the system as a whole can be used
in a wide range of clinical areas including general surgery, urology, gynecology, andEar, Nose and Throat (ENT) surgery. VISERA ELITE III enhances the quality ofendoscopic surgery, contributes to improved efficiency in the operating room, andelevates the standard of care.
As of February 2024, the system is marketed in Japan, Europe, and parts of Asia.

Olympus France S. A. S.
Regional Repair Centre
France(Paris)

Olympus Trading (Shanghai) Limited
China(Shanghai)
Olympus Service Facility Portugal– Tecnologias Opticas e Digitais, Lda.
Regional Repair Centre
Portugal(Coimbra)

Olympus America de Mexico, S.A. de C.V.
Mexico(Mexico city)

KeyMed (Ireland) Ltd.
Ireland(Dublin)

Olympus Hong Kong and China Limited
China(Hong Kong)

VISERA ELITE III

KeyMed (Medical & Industrial Equipment) Ltd.
Regional Repair Centre
UK(Southend-on-sea)

Present

Olympus (Malaysia) Sdn. Bhd.
Malaysia(Selangor Darul Ehsan)

Olympus (Guangzhou) Industrial Co., Ltd.
China(Guangzhou)

Fluorescence Imaging
In 2021, we expanded our portfolio in the growing fluorescence imaging market in thearea of surgical imaging with the acquisition of Quest Photonic Devices B.V., a Dutch
medical device manufacturer.

Olympus MEA FZ-LLC
UAE(Dubai)

Olympus Singapore Pte. Ltd.
Singapore(Singapore)

Olympus Medical Systems
Vietnam Co.,Ltd.
Vietnam(Ho Chi Minh)

Olympus Australia Pty Ltd
Australia(Melbourne)

Olympus New Zealand Limited
New Zealand(Auckland)

Endoscopes are precision instruments used within the human body. High-quality, after-sales service is necessary to maintainsafety and provide maximum functionality. In order for patients around the world to receive safe endoscopic examinations
and treatment, Olympus has established the industry's leading global repair and services system. In addition, we haveestablished a system in which each repair site can provide mutual backup in the event of an emergency such as a disaster.

Spectrum ®

FutureMolecular Imaging
Research on molecular imaging technology to visualize cancer lesions using fluorescent drugs combined with antibodies
that specifically bind to cancer is currently underway and is expected to be put to practical use. Quest Photonic Devices
B.V., works with biotechnology companies that are developing next-generation molecular imaging dyes. These innovative

The World's Largest Endoscope Repair Center (San José, California, U.S.)
Olympus is proud of the“ San José National Repair Service Center, ”which is the world ’slargest endoscope repair center. Within the walls of the 80,000 square-meter building
accented in blue, Olympus ’corporate color, 450 service staff members dressed in whitelab coats meticulously carry out their repair work. The San José location was establishedin 1979 to perform concentrated, authentic repairs (major repairs)*, including full
instrument disassembly and reassembly. Prior to this, major repairs of endoscopes had
been performed at small service locations distributed throughout the U.S. However, it was
decided that a centralized location where high-quality repairs coexisting with rapid repair
turnaround was critical for the U.S. market. The centralization of major endoscope repair
in one facility has improved both the quality and the efficiency of delivering repair services
to our customers.

dyes may enable Quest Photonic Devices B.V.’s technology to advance diagnostic opportunities in fluorescence-guided
cancer surgery.

Olympus Optical do Brasil, Ltda.
Brazil(Sao Paulo)

Map of Olympus’repair locations around the world ( ● shows locations capable of major repairs*) (As of April 2018)● Imaging System for Fluorescence-guided Surgery

Fluorescence imaging refers to special light imaging technologies that utilize theproperties of fluorescent dyes directed to specific anatomical structures. By using
targeted dyes, in combination with specific light wavelengths, tissues or lesions thatare nearly invisible under normal white light become visible.
We have added Spectrum® to our portfolio, a fluorescence-guided surgical imaging
system for both open and laparoscopic surgery.

Olympus (Thailand) Co., Ltd.
Thailand(Bangkok)

High Repair Quality
Endoscopes, which are inserted directly into the human body, must meet strict safety andperformance standards. This applies both to new instruments and instruments being returned
to healthcare professionals following service. Therefore, it is required that fully repaired items
have the same level of quality as new products. "Safe, stable use" is one of the essential valuesof endoscopes. With this kind of thinking, Olympus has continued to strive to enhance its
service system, ever since the start of the endoscope business in 1952.

World's largest endoscope repair center(San José, California)*Major repairs: An overhaul involving the dismantling, inspection, and repair of malfunctioning equipment

1415

2 Supporting endoscopist training

3 Craftsmanship for meeting physician needs

Demand for early diagnosis and minimally invasive treatment is expanding along with the rapid economic growth in China
and other Asian countries. Like in Japan, the U.S., and Europe, Olympus actively supports training for endoscopists byproviding training opportunities on the safe and effective use of Olympus products, which allows doctors to be familiar withnew products and procedures in China and other Asian countries.

NaganoMedical equipment related components

EuropeNorth America

Efforts in China
In addition to the progress which the Chinese government is making in reforming medical care,‘s population is also rapidly aging in a manner similar to U.S. and European countries.
China
In medical facilities, therefore, the number of endoscopists are unable to keep up with thegrowing number of patients, making the development of new endoscopists an urgent matter.
In 2008, Olympus built the China Medical Training & Education Center Shanghai in the researchand industry development district outside of Shanghai in China. This site is conveniently locatednear Shanghai Airport, making it easy for doctors to visit from all over China. Behind the futuristic
exterior of the building are located both a training center and a call center. The training center is
set up to allow for the training of gastrointestinal endoscopic examinations, as well as training
on the operation of endotherapy devices and surgical products. A lecture hall capable of seatingclose to 100 people is located on the uppermost floor and is wired for high-capacity broadband
communications, making academic exchange possible for doctors both inside and outside China.
Training of sales representatives and repair and service technicians is also performed at
China Medical Training & Education Center Shanghai, which contributes to improving thequality of Olympus’marketing services. The call center handles communications with medical
facilities, sales representatives, repair technicians, and dealers throughout the country, withan equivalent level to that of Japan, U.S., Europe. Olympus opened similar training centers
in Beijing in 2010 and in Guangzhou in 2013, further accelerating support for training new
Chinese endoscopists. Based at the three in-house training centers, as well as at collaborative
training centers affiliated with nationwide, Olympus is supporting training for endoscopists
throughout China by providing a range of learning programs. Olympus also invites Japanese
doctors to China who tutor Chinese trainers. Most recently, we have been supporting
Japanese doctors who provide online lectures on the activities of Chinese trainers andevaluate as well as comment on case presentations. Through these and other efforts,
Olympus has achieved remarkable growth in recent years.

Bartlett (U.S.)
ENT devices

Revenue in China

Olympus China Medical Training &Education Center Shanghai(C-TEC Shanghai)

(%)

120

16

90

12

60

8

30

4

0

0

FY2013

FY2015FY2016FY2017FY2018FY2019FY2020

FY2021

FY2022

Click here for the China page of
our Integrated Report 2023
Medical Business Strategy:
Chinese Market“ Chinese Market
with High Growth Potential”

16

Approx.

4.3 times
Comparison between sales

Hamburg (Germany)
Rigid endoscopes

HinodeProduction start-up and manufacture of
new element products

Prerov (Czech)
Urology devices
Berlin (Germany)
High-frequency generators

Long Thanh (Vietnam)
Endotherapy devices

Strength in Advanced Manufacturing Technology
The factories in Japan develop and manufacture gastrointestinal endoscope systems from basic components and have aunique strength in manufacturing that requires a high level of precision and one-of-a-kind assembly expertise on the part ofthe manufacturing staff. Flexible endoscopes are manufactured exclusively at the Aizu factory. For the main components ofthe endoscope, such as the imaging unit, control section, and electrical connector, there are plans to unify development andmanufacturing and to isolate and develop essential key technologies, while realizing high-mix, low-volume production. For
example, Olympus decided to develop the machining equipment necessary to manufacture the stainless steel distal tip of theendoscope in-house, thus keeping this knowledge within the company. Products manufactured by the Shirakawa factory
include video processors and light sources for endoscopes, ultrasound endoscopes, and capsule endoscopes. The strengths
here are component technologies for electrical equipment (including semiconductors and circuit boards), circuit design, andquality assurance. By employing the Kaizen (improvement) activity, quality improves daily and production lead times aredramatically shrinking. The Aomori factory features high-tech production of endotherapy devices. The factory specializes intherapeutic devices such as electrosurgical snares for gastrointestinal polypectomy, devices for use in biliary ducts, etc. The
Hinode factory manufactures disposable products and prototypes. The Vietnam factory, which was established as a satellite
factory of the Aomori facility, produces endotherapy devices and related products.

in the Chinese market for
FY2023 and FY2013

FY2023

Efforts in Asian Countries
With a total population of over 1.3 billion people, India is the most promising new market
second to China. From the size of its population and the speed of its economic growth,
it is believed that the availability and use of medical devices in India will advance rapidly inthe future. Similar to Japan and China, there are a number of gastrointestinal diseases inIndia amenable to endoscopic treatment, and endoscopic procedures for biliary andpancreatic diseases are very common. Olympus works with Indian academic societies andsupports endoscopic training sessions. Having established a training center in Thailand in2016 to serve healthcare professionals from Southeast Asia, Olympus is also striving todevelop the medical technology infrastructure in the nations of the region and expand theiruse of endoscopy. Furthermore, Olympus Korea Medical Training & Education Center(K-TEC) was established in 2017. In the future, Olympus intends to continue contributing
to improvements in patient quality of life (QOL) by working to help with endoscopy skill
development and on the wider use of endoscopes for early diagnosis, minimally invasive
treatment, and procedure.

Southend-on-Sea (UK)
Endoscope peripherals (trolleys, insufflators, etc.)

Various forms of training can be given
within the facility

20

FY2014

ShirakawaVideo system centers (image processors),
light sources, ultrasound endoscopes

Plymouth (UK)
Medical equipment-related components

The current trilateral approach of Japan/Asia, North America, and Europe is supported by the following manufacturing
centers. In Japan and Asia, we have five domestic plants in Aizu, Shirakawa, Aomori, Hinode (Tokyo), and Nagano, and aplant in Vietnam. All of our mainstay gastrointestinal endoscopes are manufactured in Japan. Surgical devices are
manufactured in North America based at the two manufacturing facilities. The main products are surgical devices for ear,nose and throat and surgical energy devices. In Europe, rigid endoscopes, therapeutic devices for urology/gynecology,
surgical energy devices and endoscope-related equipment are manufactured at six sites in Germany, the Czech Republic
and the UK.

Ratio of Revenue in China Accounted for by Medical Business Sales

150

Aizu
Endoscopes,
endoscope reprocessors

Cardiff (UK)
Surgical energy devices

Chinese Sales Growth Trends in the Medical Business(¥ Billion)

Japan/Asia

Brooklyn Park (U.S.)
Surgical energy devices

AomoriEndotherapy devices,
surgical energy devices

Olympus Korea Medical Training &Education Center (K-TEC)
Click here for the Asian Countries page of
our Integrated Report 2023 Medical
Business Strategy:
Asian Emerging Markets“Support forTraining of Endoscopists andContribution to Strengthening Medical
Infrastructure in Asian Countries”

Characteristics of Endoscopy System Manufacturing
Techniques that Realize High-Mix, Low-Volume Production
The number of different variations of endoscopes we offer
grows each year, and we currently offer more than 300
different models of endoscopes. Creating endoscopes
requires sophisticated manufacturing technologies as wellas high-mix, low-volume production systems. On top of
fulfilling these requirements, we have maintained a stancetoward production that compels us to develop components
and equipment ourselves should the market be unable tosupply us with items that meet our expectations forcraftsmanship. As the components of endoscopes haveincredibly intricate structures, it is impossible to findready-made blades for their production. Therefore, eachtime we need to develop new endoscope components, westart by creating custom blades and other tools capable ofmeeting our design specifications. The unique products
Olympus offers are the result of an ongoing, comprehensive
process of in-house craftsmanship, which entails resolving
issues on our own. This thorough process has enabled us toearn the trust from the world that we hold today.

Detailed eye for customer needs
High-Mix, Low-Volume Production
In-house development of materials, capabilities, and craftedcomponents not otherwise available
High-precision crafting technologies that create components
accurate to the micronJapanese assembly technologies that make fine adjustments
based on combinations of various technologies and expertise

High-precision endoscope tips

Highly precise scope assembly process17