| Scissors precious to and pervasive in many medical procedures and surgeries. The surgical instrument, valued close to $3.78 billion in 2002, is regulated for product performance, quality and safety, and manufacturing processes. At the same time it is characterized by technological advances, tough competition and price sensitivity. The market comprises manufacturers and suppliers that are multinational companies, large, mid-size and small manufacturers. Most of the surgical instrument manufacturers of the world are located in Western Europe (Germany), North America, and Pakistan.