ENGLISH 25 5. Significance for Tuttlingen: Strengths, risks and potential Tuttlingen has established itself as the international center for surgical instruments over more than a century. Big names, local expertise, an artisanal heritage, and modern production lay a strong foundation. Companies such as Aesculap and Karl Storz are the biggest players, although smaller manufacturers also enrich the ecosystem with their specialist knowledge and flexibility. But the challenges outlined above apply here as well: regulatory requirements, rising costs, a shortage of skilled workers, fierce competition, and succession issues. In many cases, small and medium-sized manufacturers are forced to decide whether they can invest in certification, new technologies, or automation, or whether they should give up, cut back, or retreat into niche areas. But the potential remains huge: Those who focus on innovation at an early stage – whether it’s novel materials, digital production or smart instruments – can secure a competitive edge. Increased inter-enterprise collaboration, research institutions and authorities could also help to overcome regulatory and technological hurdles. 6. Summary and outlook The medical technology sector in Germany – and the subsector of surgical instruments in particular – is built on solid foundations: a large network of small to medium-sized enterprises, strong exports, outstanding quality Tuttlingen „World Center for Medical Technology“ (Quelle ACIG)
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