Boston's other charms — the nearness to the Atlantic Ocean, and the short drive to mountains and lakes, as well as the city's arts and cultural offerings — help to attract well-paid employees to the sector. Direct flights to major European and Asian cities also help companies conduct business internationally.

As the device companies research and test new products, many work with surgeons at the teaching hospitals. Some companies have their physicians sit in on surgeries to examine their products at work or improve the existing technology. Surgeons also are invited to the companies to discuss potential new products.

The Massachusetts Medical Device Industry Council (MassMedic), which brings together manufacturers, product developers, suppliers, research institutions and health centers, has grown to 400 from 300 members about four years ago.

Steve Clancy, executive vice president of CB Richard Ellis New England, has watched the medical device industry blossom over the past two decades as he sold or leased 25 million sq. ft. of industrial, office and research space.

The sector's growth has largely been unheralded, he says. Fostered by the scientific climate near Harvard and MIT, some companies sprang to life in Cambridge and then moved to the suburbs, where industrial space costs a fraction of the $60 per sq. ft. of Cambridge.

The broker saw the little machine and metalworking shops and small-town silversmiths drawn into the lucrative and precise medical instrument trade. When they grew large enough, big out-of-state corporations made them offers they couldn't refuse, leaving a number of companies owned by foreign or U.S. giants based outside the state.

In July, Theragenics, a medical device firm based in Buford, Ga., announced it would pay $47.8 million in cash for privately held Needle Tech, a needle manufacturer in Attleboro, Mass. that earned $16.9 million in revenue last year. Theragenics Chairman and CEO Christine Jacobs called the acquisition “a good fit” for the Georgia firm, whose output includes a product used to treat prostate cancer through radiation therapy.

“Needle Tech was in an old mill building in the bowels of Attleboro. It was a classic example of what I'm talking about,” says Clancy. Even as Boston's office and industrial sectors begin to show signs of strain under the pressure of the nation's economic and credit constraints, with negative absorption in certain sections of the metro area, he remains optimistic about the medical device industry.

The Greater Boston industrial market experienced negative absorption of roughly 523,000 sq. ft. in the third quarter of 2008, CB Richard Ellis reports, a worsening performance from negative second-quarter net absorption of about 200,000 sq. ft.