U.S. SURGICAL PROCEDURE VOLUMES

448 Pages | 106 Exhibits | 2009 Analysis | Forecasts Through 2015 Product Family: Market Reports




OVERVIEW:
The number of surgical procedures performed in the United States (U.S.) is increasing; however, the share of inpatient hospitalizations is decreasing in favor of patient visits to freestanding clinics and physician offices. Office-based procedures are projected to grow at a compound annual rate of 5.4% over the forecast period covered by this report; this is a slower rate than during the past decade due to the curtailment in demand for elective surgery during the 2009 to 2010 period due adverse economic conditions. (These same economic conditions are expected to contribute to the overall slowdown in elective procedures in other outpatient facilities during this period.) In 2007, inpatient surgical procedures accounted for approximately 35% of all surgical procedures performed in the U.S. In the year 2015, approximately 25.0% of all surgical procedures are expected to be inpatient procedures; the remaining surgeries are expected to be performed in freestanding facilities, physician offices, or in hospitals as outpatient procedures. Outpatient settings offer same-day surgery and improved, less invasive surgical techniques to speed patient recovery. Treatment advances such as new drug therapy also have contributed to fewer and shorter hospital stays.

This dynamic new report from Medtech Insight features selected U.S. surgical procedure volumes as well as an overview of each procedure, etiology and epidemiological data for the disease/disorder treated by the procedure, surgical trends, and emerging surgical treatments. The forecast period covered by this report is for the years 2007 through 2015. Surgical procedures covered include those in the following categories: cardiovascular/thoracic, cosmetic, general, obstetric/ gynecologic, major organ/tissue transplantation, ophthalmic, orthopedics/spine, urology, and miscellaneous.

Covered topics in this report include abdominal and bariatric surgery; aneurysm and myocardial repair; appendectomy; arrhythmia and circulatory disorders; bone marrow and organ transplantation; breast and organ biopsy; cardiac device implantation; cataract, glaucoma, and refractive surgery; ear, nose, and throat procedures; fracture repair and bone grafts; hysterectomy; incontinence management; infertility diagnostic procedures; inguinal herniorrhaphy; joint arthroscopy and replacement; mastectomy; nephrectomy; plastic surgery; prostatic procedures; splenectomy; stone removal; strabismus correction; and vitrectomy.

TABLE OF CONTENTS:
INTRODUCTION 

i. Report Methodology 

1. CARDIOVASCULAR/THORACIC SURGICAL PROCEDURES 

1.1 Cardiovascular Disease 
	1.1.1 Prevalence and Mortality 
	1.1.2 Etiology and Epidemiology 
		1.1.2.1 Arrhythmia 
			1.1.2.1.1 Atrial Fibrillation 
			1.1.2.1.2 Supraventricular Tachycardia 
			1.1.2.1.3 Ventricular Fibrillation 
			1.1.2.1.4 Ventricular Tachycardia 
		1.1.2.2 Circulatory Disorders 
			1.1.2.2.1 Coronary Artery Disease 
			1.1.2.2.2 Myocardial Infarction 
			1.1.2.2.3 Angina Pectoris 
			1.1.2.2.4 Aortic Aneurysm 
			1.1.2.2.5 Atherosclerosis 
			1.1.2.2.6 Hypercholesterolemia 
			1.1.2.2.7 Hypertension 
			1.1.2.2.8 Venous Thromboembolism: Deep Vein Thrombosis and Pulmonary Embolism 
		1.1.2.3 Myocardial Diseases/Disorders 
			1.1.2.3.1 Congenital Heart Defects 
			1.1.2.3.2 Heart Failure 
			1.1.2.3.3 Rheumatic Heart Disease 
			1.1.2.3.4 Valvular Heart Disease 
1.2 Aneurysm Repair 
1.3 Coronary Artery Disease Treatment 
	1.3.1 Coronary Artery Bypass Graft Surgery 
		1.3.1.1 Less Invasive Coronary Artery Bypass Graft Techniques 
	1.3.2 Percutaneous Coronary Intervention 
		1.3.2.1 Atherectomy/Laser Angioplasty 
		1.3.2.2 Percutaneous Transluminal Coronary Angioplasty/Coronary Stenting 
	1.3.3 Transmyocardial Revascularization 
1.4 Peripheral Artery Disease Treatment 
	1.4.1 Femoropopliteal Bypass 
	1.4.2 Peripheral Percutaneous Revascularization Techniques 
		1.4.2.1 Peripheral Percutaneous Transluminal Angioplasty 
		1.4.2.2 Peripheral Atherectomy 
		1.4.2.3 Peripheral Femoropopliteal Stenting
		1.4.2.4 Thrombolysis and Thrombectomy 
1.5 Heart Defect Repair 
	1.5.1 Congenital Heart Defect Repair 
	1.5.2 Heart Valve Repair and Replacement 
1.6 Cardiac Device Implantation 
	1.6.1 Cardiac Resynchronization Therapy 
	1.6.2 Pacemakers 
	1.6.3 Automatic Implantable Cardioverter Defibrillators 
	1.6.4 Ventricular Assist Devices 
1.7 Thoracic Surgery 
	1.7.1 Thoracotomy 
	1.7.2 Thoracoscopy 

Exhibit 1-1: 2008, Cardiovascular Disease and Stroke, Estimated Direct and Indirect Costs 
Exhibit 1-2: Cardiovascular Disease, Prevalence and Mortality Statistics 
Exhibit 1-3: Aneurysm Repair, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 1-4: Coronary Artery Bypass Graft Surgery, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 1-5: On-Pump and Off-Pump Coronary Artery Bypass Graft Surgery,  Procedure Volumes Forecast, 2007-2015 
Exhibit 1-6: Coronary Atherectomy and Laser Angioplasty, Procedure Volumes Forecast, 2007-2015 
Exhibit 1-7: Percutaneous Transluminal Coronary Angioplasty/Coronary Stenting, Procedure Volumes Forecast, 2007-2015 
Exhibit 1-8: Femoropopliteal Bypass, Procedure Volumes Forecast, 2007-2015 
Exhibit 1-9: Peripheral Percutaneous Transluminal Angioplasty, Procedure Volumes Forecast, 2007-2015 
Exhibit 1-10: Peripheral Atherectomy, Procedure Volumes  Forecast, 2007-2015 
Exhibit 1-11: Femoropopliteal Stenting, Procedure Volumes  Forecast, 2007-2015 
Exhibit 1-12: Thrombolysis and Thrombectomy, Procedure Volumes Forecast, 2007-2015 
Exhibit 1-13: Congenital Heart Defect Repair, Procedure Volumes  Forecast, 2007-2015 
Exhibit 1-14: Heart Valve Replacement and Repair, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 1-15: Pacemaker Implantation and Replacement, Procedure Volumes Forecast, 2007-2015 
Exhibit 1-16: Automatic Implantable Cardioverter Defibrillator Implantation, Procedure Volumes Forecast, 2007-2015 
Exhibit 1-17: Ventricular Assist Device Implantation, Procedure Volumes Forecast, 2007-2015 
Exhibit 1-18: Thoracotomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 1-19: Video-Assisted Thoracic Surgery versus Open Thoracotomy 
Exhibit 1-20: Thoracoscopy, Procedure Volumes Forecast, 2007-2015 

2. COSMETIC SURGICAL PROCEDURES
 
2.1 Abdominoplasty 
2.2 Augmentation and Reduction Mammoplasty 
2.3 Blepharoplasty 
2.4 Hair Transplantation
2.5 Liposuction 
2.6 Rhytidectomy 
2.7 Trends in Cosmetic Surgery 

Exhibit 2-1: Abdominoplasty, Procedure Volumes Forecast, 2007-2015 
Exhibit 2-2: Augmentation and Reduction Mammoplasty, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 2-3: Blepharoplasty, Procedure Volumes Forecast, 2007-2015 
Exhibit 2-4: Hair Transplantation, Procedure Volumes Forecast, 2007-2015
Exhibit 2-5: Liposuction, Procedure Volumes Forecast, 2007-2015 
Exhibit 2-6: Rhytidectomy, Procedure Volumes Forecast, 2007-2015 

3. GENERAL SURGICAL PROCEDURES 

3.1 Abdominal Adhesiolysis 
3.2 Appendectomy 
3.3 Bariatric Surgery
3.4 Cholecystectomy 
3.5 Esophagogastric Fundoplasty 
3.6 Inguinal Herniorrhaphy 
3.7 Large Intestine Procedures 
	3.7.1 Colectomy and Sigmoidectomy 
	3.7.2 Hemorrhoid Surgery 
3.8 Liver Biopsy 

Exhibit 3-1: Open and Laparoscopic Abdominal Adhesiolysis, Procedure Volumes Forecast, 2007-2015 
Exhibit 3-2: Open and Laparoscopic Appendectomy, Procedure Volumes Forecast, 2007-2015 
Exhibit 3-3: Open and Laparoscopic Bariatric/Gastric Bypass, Procedure Volumes Forecast, 2007-2015 
Exhibit 3-4: Open and Laparoscopic Cholecystectomy, Procedure Volumes Forecast, 2007-2015 
Exhibit 3-5: Open and Laparoscopic Esophagogastric Fundoplasty, Procedure Volumes Forecast, 2007-2015 
Exhibit 3-6: Open and Laparoscopic Inguinal Herniorrhaphy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 3-7: Colectomy and Sigmoidectomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 3-8: Hemorrhoidectomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 3-9: Outpatient Hemorrhoidectomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 3-10: Open and Closed Liver Biopsy, Procedure Volumes Forecast, 2007-2015 

4. MAJOR ORGAN/TISSUE TRANSPLANTATION

4.1 Donor Shortage 
4.2 Overview of Organ Transplantation 
	4.2.1 Immunosuppressive Strategies 
	4.2.2 Transplantation Data 
4.3 Bone Marrow and Cord Blood Transplantation 
	4.3.1 Nonmyeloablative Transplants 
	4.3.2 Syngeneic Transplants 
	4.3.3 Allogeneic Transplants 
	4.3.4 Autologous Transplants 
	4.3.5 Alternative Sources of Stem Cells 
4.4 Corneal Transplantation 
4.5 Heart Transplantation
	4.5.1 Heart-Lung Transplantation
4.6 Intestinal Transplantation 
4.7 Kidney Transplantation 
4.8 Liver Transplantation 
4.9 Lung Transplantation 
4.10 Pancreas Transplantation 
	4.10.1 Pancreas-Kidney Transplantation 

Exhibit 4-1: Patients Awaiting Organ Transplants, by Transplant Type
Exhibit 4-2: 2008, Organ Transplant Programs, by Type 
Exhibit 4-3: 2007, Major Organ Transplantation, by Type 
Exhibit 4-4: Patient Survival Rates at One and Five Years,  by Organ Transplanted 
Exhibit 4-5: Cadaveric and Living Donor Organ Transplants, 1997-2007 
Exhibit 4-6: Major Organ Transplantation, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 4-7: 2007, Unrelated Bone Marrow and Cord Blood Transplants, by Patient Diagnosis 
Exhibit 4-8: Diseases/Disorders Treated by Bone Marrow Transplantation 
Exhibit 4-9: Corneal Transplantation, Procedure Volumes Forecast, 2007-2015
Exhibit 4-10: Heart Transplantation, Patient Survival Rates, 2000-2005 
Exhibit 4-11: Heart-Lung Transplantation, Patient Survival Rates, 2000-2005 
Exhibit 4-12: Intestinal Transplantation, Patient Survival Rates, 2000-2005 
Exhibit 4-13: Living Donor Kidney Transplantation, Patient Survival Rates, 2000-2005
Exhibit 4-14: Deceased Non-Expanded Criteria Donor Kidney Transplantation, Patient Survival Rates, 2000-2005 
Exhibit 4-15: Deceased Expanded Criteria Donor Kidney Transplantation, Patient Survival Rates, 2000-2005 
Exhibit 4-16: Living Donor Liver Transplantation, Patient Survival Rates, 2000-2005 
Exhibit 4-17: Deceased Donor Liver Transplantation, Patient Survival Rates, 2000-2005 
Exhibit 4-18: Living Donor Lung Transplantation, Patient Survival Rates, 2000-2005 
Exhibit 4-19: Deceased Donor Lung Transplantation, Patient Survival Rates, 2000-2005 
Exhibit 4-20: Pancreas and Pancreas-Kidney Transplantation, Patient Survival Rates, 2000-2005 

5. NEUROSURGICAL PROCEDURES
 
5.1 Stroke 
5.2 Cerebral Aneurysms 
5.3 Arteriovenous Malformations 
5.4 Central Nervous System Tumors
5.5 Traumatic Brain Injury 
5.6 Hydrocephalus and Increased Intracranial Pressure 
5.7 Surgical Procedures 
	5.7.1 Cerebrospinal Fluid Shunting and Drainage 
	5.7.2 Carotid Endarterectomy and Thromboendarterectomy 
5.8 Minimally Invasive Neurointerventional Surgery 
	5.8.1 Neurovascular Balloon Angioplasty 
	5.8.2 Carotid Artery Stenting 
5.9 Aneurysm Repair 
	5.9.1 Surgical Aneurysm Clips 
	5.9.2 Embolization of Cerebral Aneurysms

Exhibit 5-1: Ventricular Shunting, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 5-2: Carotid Endarterectomy and Thromboendarterectomy, Procedure Volumes Forecast, 2007-2015 
Exhibit 5-3: Brachiocephalic Percutaneous Transluminal Angioplasty, Procedure Volumes Forecast, 2007-2015 
Exhibit 5-4: Carotid Artery Stenting, Procedure Volumes Forecast, 2007-2015 
Exhibit 5-5: Cerebral Aneurysm Clipping, Procedure  Volumes Forecast, 2007-2015 
Exhibit 5-6: Cerebral Aneurysm Embolization, Procedure Volumes Forecast, by Type, 2007-2015 

6. OBSTETRIC/GYNECOLOGIC SURGICAL PROCEDURES 

6.1 Abnormal Uterine Bleeding 
6.2 Laparoscopic and Open Gynecologic Procedures 
	6.2.1 Dilation and Curettage 
	6.2.2 Hysterectomy
		6.2.2.1 Minimally Invasive Hysterectomy 
	6.2.3 Hysteroscopy 
		6.2.3.1 Endometrial Ablation 
		6.2.3.2 Myomectomy 
	6.2.4 Infertility Diagnostic Procedures 
		6.2.4.1 Hysterosonography, Hysterosalpingography, and Laparoscopy 
6.3 Female Sterilization 
	6.3.1 Tubal Ligation 
6.4 Obstetric Procedures
	6.4.1 Cesarean Section

Exhibit 6-1: Dilation and Curettage, Procedure Volumes Forecast, by Setting, 2007-2015 
Exhibit 6-2: Hysterectomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 6-3: Hysteroscopy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 6-4: Myomectomy, Procedure Volumes Forecast, 2007-2015 
Exhibit 6-5: Uterine and Tubal Patency Screening, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 6-6: Tubal Ligation, Procedure Volumes Forecast, 2007-2015 
Exhibit 6-7: Live Births, Historical Procedure Volumes, 1990-2005 
Exhibit 6-8: Live Births, Procedure Volumes Forecast, 2005-2015
Exhibit 6-9: Cesarean Section Delivery, Procedure Volumes  Forecast, 2007-2015 

7. OPHTHALMIC SURGICAL PROCEDURES 

7.1 Age-Related Macular Degeneration 
	7.1.1 Photodynamic Therapy 
	7.1.2 Transpupillary Thermotherapy 
7.2 Cataract Surgery 
	7.2.1 Capsulotomy 
7.3 Diabetic Retinopathy 
7.4 Glaucoma 
7.5 Refractive Surgery 
	7.5.1 Radial Keratotomy
	7.5.2 Photorefractive Keratotomy 
	7.5.3 Laser-Assisted In Situ Keratomileusis 
7.6 Strabismus Correction 
7.7 Vitrectomy 

Exhibit 7-1: Age-Related Macular Degeneration Laser Surgery, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 7-2: Cataract Surgery and Capsulotomy, Procedure Volumes Forecast, 2007-2015 
Exhibit 7-3: Diabetic Retinopathy Laser Surgery, Procedure Volumes Forecast, 2007-2015 
Exhibit 7-4: Glaucoma Surgery, Procedure Volumes Forecast, 2007-2015 
Exhibit 7-5: Refractive Surgery, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 7-6: Strabismus Correction, Procedure Volumes Forecast, 2007-2015 
Exhibit 7-7: Vitrectomy, Procedure Volumes Forecast, 2007-2015 

8. ORTHOPEDIC/SPINE SURGICAL PROCEDURES 

8.1 Fracture Repair 
	8.1.1 Bone Grafts 
	8.1.2 Biotechnology in Fracture Repair 
8.2 Total Joint Arthroplasty 
	8.2.1 Total Knee Arthroplasty 
		8.2.1.1 Unicompartmental Knee Arthroplasty 
	8.2.2 Hip Arthroplasty 
		8.2.2.1 Revision Hip Arthroplasty 
8.3 Spine Surgery 
	8.3.1 Disc Arthroscopy 
	8.3.2 Nerve Root Compression 
		8.3.2.1 Discectomy 
		8.3.2.2 Laminectomy and Laminotomy 
	8.3.3 Spinal Fusion 
		8.3.3.1 Anterior Lumbar Interbody Fusion 
		8.3.3.2 Posterior Lumbar Interbody Fusion 
		8.3.3.3 Lateral Lumbar Interbody Fusion 
		8.3.3.4 Instrumented Fusion
	8.3.4 Vertebroplasty 
8.4 Arthroscopy 
	8.4.1 Knee Arthroscopy 
		8.4.1.1 Cartilage Repair and Transplantation 
		8.4.1.2 Meniscectomy 
		8.4.1.3 Anterior Cruciate Ligament Reconstruction 
	8.4.2 Shoulder Arthroscopy 
		8.4.2.1 Primary Anterior Shoulder Dislocation 
		8.4.2.2 Recurrent Anterior Shoulder Dislocation 
		8.4.2.3 Acromioclavicular Joint Resection 
		8.4.2.4 Rotator Cuff Repair
	8.4.3 Wrist Arthroscopy 
		8.4.3.1 Carpal Tunnel Release

Exhibit 8-1: Open Reduction with Internal Fixation of the Femur or Tibia/Fibula, Procedure Volumes Forecast, 2007-2015 
Exhibit 8-2: Primary and Revision Knee Replacement, Procedure Volumes Forecast, 2007-2015 
Exhibit 8-3: Unicompartmental Knee Arthroplasty, Procedure Volumes Forecast, 2007-2015
Exhibit 8-4: Primary Total and Partial Hip Replacement, Procedure Volumes Forecast, 2007-2015 
Exhibit 8-5: Revision Hip Replacement, Procedure  Volumes Forecast, 2007-2015 
Exhibit 8-6: Discectomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 8-7: Laminectomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 8-8: Laminotomy, Procedure Volumes, by Type, 2007-2015 
Exhibit 8-9: Spinal Fusion and Refusion, Procedure Volumes Forecast, 2007-2015 
Exhibit 8-10: Spinal Fusion, Procedure Volumes Forecast, by Anatomic Site, 2007-2015 
Exhibit 8-11: Arthroscopic Knee Surgery, Procedure Volumes Forecast, 2007-2015 
Exhibit 8-12: Meniscectomy and Meniscal Repair, Procedure Volumes Forecast, 2007-2015 
Exhibit 8-13: Arthroscopic and Open Anterior Cruciate Ligament Reconstruction, Procedure Volumes Forecast, 2007-2015 
Exhibit 8-14: Arthroscopic Shoulder Surgery, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 8-15: Carpal Tunnel Release, Procedure Volumes Forecast, 2007-2015 

9. UROLOGIC SURGICAL PROCEDURES 

9.1 Incontinence Management 
9.2 Nephrectomy 
9.3 Prostate Procedures 
	9.3.1 Prostatectomy 
	9.3.2 Transurethral Resection of the Prostate 
	9.3.3 Minimally Invasive Benign Prostatic Hyperplasia Therapy 
9.4 Stone and Obstruction Removal 

Exhibit 9-1: Stress Urinary Incontinence Suspensions and Slings, Procedure Volumes Forecast,  by Type, 2007-2015 
Exhibit 9-2: Nephrectomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 9-3: Prostatectomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 9-4: Benign Prostatic Hyperplasia Therapy, by Type, Procedure Volumes Forecast, 2007-2015 
Exhibit 9-5: Minimally Invasive Benign Prostatic Hyperplasia Therapy, Procedure Volumes Forecast,  by Type, 2007-2015
Exhibit 9-6: Kidney Stone Removal, Procedure Volumes Forecast, by Type, 2007-2015 

10. MISCELLANEOUS SURGICAL PROCEDURES 

10.1 Breast Procedures 
	10.1.1 Biopsy 
		10.1.1.1 Surgical Biopsy 
		10.1.1.2 Percutaneous Biopsy 
		10.1.1.3 Vacuum-Assisted Biopsy 
		10.1.1.4 Lumpectomy 
	10.1.2 Mastectomy 
		10.1.2.1 Prophylactic Mastectomy 
		10.1.2.2 Simple Mastectomy 
		10.1.2.3 Radical and Modified Radical Mastectomy 
10.2 Ear, Nose, and Throat Procedures 
	10.2.1 Sinus Procedures 
	10.2.2 Tonsillectomy/Adenoidectomy 
	10.2.3 Tracheotomy 
10.3 Splenectomy 

Exhibit 10-1: Breast Biopsy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 10-2: Lumpectomy, Procedure Volumes Forecast, 2007-2015 
Exhibit 10-3: Mastectomy, Procedure Volumes Forecast, by Type, 2007-2015 
Exhibit 10-4: Endoscopic and Inpatient Sinus Surgery, Procedure Volumes Forecast, 2007-2015 
Exhibit 10-5: Tonsillectomy, Adenotonsillectomy, and Adenoidectomy, Procedure Volumes Forecast,  by Type, 2007-2015 
Exhibit 10-6: Planned and Emergency Tracheotomy, Procedure Volumes Forecast, 2007-2015 
Exhibit 10-7: Splenectomy, Procedure Volumes Forecast, 2007-2015 


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