SPAIN, SURGICAL PROCEDURE VOLUMES

313 Pages | 66 Exhibits | 2009 Analysis | Forecasts Through 2013

OVERVIEW:
In 2008, the population of Spain reached approximately 40.5 million, with the number of people age 65 and older comprising 17.9% of the total population; this represented an increase of 10.6% over the number of people in this age group in 1998. By the year 2018, it is estimated that 20.2% of the population of Spain will be age 65 and older. A combination of factors including the aging of the population in the region, the introduction of innovative technologies, patient demand for improved quality of life, and evolving reimbursement practices are driving the trend away from traditional open and invasive surgical procedures toward minimally invasive and laparoscopic surgery.

Due to the increasing use of laparoscopic techniques, over the next five years, double-digit expansion is projected in a number of procedures including adrenalectomy, cardiac device implantation, coronary artery surgery, endometrial ablation, minimally invasive spinal fixation, peripheral vascular surgery, prostate disease/disorder management, and total disc replacement.

The surgical procedures covered by this report include cardiovascular/peripheral vascular surgery; neurosurgery; obstetric/gynecologic surgery; ophthalmic surgery; orthopedic/arthroscopic surgery; otorhinolaryngologic surgery; spine surgery; and urologic surgery as well as the general surgical areas of adrenalectomy and appendectomy, breast surgery, cholecystectomy, esophagogastric and gastroduodenal surgery, inguinal hernia repair, liver biopsy and tumor excision, and splenectomy.

This new report from Medtech Insight includes the procedure volumes forecasts for open and laparoscopic surgery in the above-mentioned areas for the EU country of Spain for the years 2008 through 2013. Topics covered by this report include an overview of European healthcare and regulatory policies, technological advancements in minimally invasive surgery, and trends in healthcare funding and reimbursement in Spain.

TABLE OF CONTENTS:
EXECUTIVE SUMMARY

i. Trends toward Minimally Invasive Surgery
ii. Cardiovascular/Peripheral Vascular Surgery
iii. General Surgery
iv. Neurosurgery
v. Obstetric/Gynecologic Surgery
vi. Ophthalmic Surgery
vii. Orthopedic/Arthroscopic Surgery
viii. Otorhinolaryngologic Surgery
ix. Spine Surgery
x. Urologic Surgery

Exhibit ES-1: Spain, Cardiovascular/Peripheral Vascular Surgery, Combined Procedure Volumes Forecast, by Type, 2008-2013
Exhibit ES-2: Spain, General Surgery, Combined Procedure Volumes Forecast, by Type, 2008-2013
Exhibit ES-3: Spain, Neurosurgery, Combined Procedure Volumes Forecast, by Type, 2008-2013
Exhibit ES-4: Spain, Obstetric/Gynecologic Surgery, Combined Procedure Volumes Forecast, by Type, 2008-2013
Exhibit ES-5: Spain, Ophthalmic Surgery, Combined Procedure Volumes Forecast, by Type, 2008-2013
Exhibit ES-6: Spain, Orthopedic/Arthroscopic Surgery, Combined Procedure Volumes Forecast, by Type, 2008-2013
Exhibit ES-7: Spain, Otorhinolaryngologic Surgery, Combined Procedure Volumes Forecast, 2008-2013
Exhibit ES-8: Spain, Spine Surgery, Combined Procedure Volumes Forecast, by Type, 2008-2013
Exhibit ES-9: Spain, Urologic Surgery, Combined Procedure Volumes Forecast, by Type, 2008-2013

1. EUROPEAN HEALTHCARE OVERVIEW

1.1 The European Union
	1.1.1 A Common Currency
	1.1.2 Regulatory Policies
	1.1.3 Reimbursement
	1.1.4 Healthcare Spending
	1.1.5 Factors Affecting European Surgical Procedure Volumes
		1.1.5.1 Technological Advancements in Minimally Invasive Surgery
		1.1.5.2 Improvements in Surgical Instrumentation
		1.1.5.3 Robot-Assisted Surgery
	1.1.6 Traditional versus Nontraditional Healthcare Delivery
		1.1.6.1 Outpatient Surgery Centers
		1.1.6.2 Long-Term and Rehabilitative Care Facilities
		1.1.6.3 Community-Based Healthcare and Homecare Agencies
1.2 Selected National Healthcare Profiles for Spain
	1.2.1 Healthcare Organization and Reform
	1.2.2 Hospital Services
	1.2.3 Medical Device Reimbursement

Exhibit 1-1: European Union, Medical Devices Risk Classification System
Exhibit 1-2: European Union Population Statistics Comparison for the Years 1998, 2008, and 2018
Exhibit 1-3: Spain, Selected National Healthcare Statistics

2. CARDIOVASCULAR/PERIPHERAL VASCULAR SURGICAL PROCEDURES

2.1 Arrhythmia
	2.1.1 Atrial Fibrillation
	2.1.2 Supraventricular Tachycardia
	2.1.3 Ventricular Fibrillation
	2.1.4 Ventricular Tachycardia
2.2 Circulatory Disorders
	2.2.1 Coronary Artery Disease
	2.2.2 Myocardial Infarction
	2.2.3 Angina Pectoris
	2.2.4 Aortic Aneurysm
	2.2.5 Atherosclerosis
	2.2.6 Hypercholesterolemia
	2.2.7 Hypertension
	2.2.8 Venous Thromboembolism: Deep Vein Thrombosis and Pulmonary Embolism
2.3 Myocardial Diseases/Disorders
	2.3.1 Congenital Heart Defects
	2.3.2 Heart Failure
	2.3.3 Rheumatic Heart Disease
	2.3.4 Valvular Heart Disease
2.4 Aneurysm Repair
	2.4.1 Surgical Aneurysm Clipping
	2.4.2 Cerebral Aneurysm Embolization
2.5 Coronary Artery Disease Treatment
	2.5.1 Coronary Artery Bypass Graft Surgery
		2.5.1.1 Less Invasive Coronary Artery Bypass Graft Techniques
	2.5.2 Percutaneous Transluminal Coronary Angioplasty/Coronary Stenting
	2.5.3 Transmyocardial Revascularization
	2.5.4 Atherectomy
	2.5.5 Thrombectomy and Thrombolysis
2.6 Peripheral Vascular Disease Treatment
	2.6.1 Carotid Artery Stenting
	2.6.2 Carotid Endarterectomy
	2.6.3 Femoropopliteal Bypass
	2.6.4 Peripheral Percutaneous Revascularization Techniques
		2.6.4.1 Peripheral Percutaneous Transluminal Angioplasty
		2.6.4.2 Peripheral Atherectomy
		2.6.4.3 Peripheral Femoropopliteal Stenting
2.7 Heart Defect Repair
	2.7.1 Congenital Heart Defect Repair
	2.7.2 Heart Valve Repair and Replacement
2.8 Cardiac Device Implantation
	2.8.1 Cardiac Resynchronization Therapy
	2.8.2 Pacemakers
	2.8.3 Implantable Cardioverter Defibrillators
	2.8.4 Ventricular Assist Devices
2.9 Heart Transplantation
	2.9.1 Heart-Lung Transplantation

Exhibit 2-1: Spain, Aneurysm Repair, Procedure Volumes Forecast, 2008-2013
Exhibit 2-2: Spain, Coronary Artery Surgery, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 2-3: Spain, Minimally Invasive Cardiovascular Intervention, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 2-4: Spain, Peripheral Vascular Surgery, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 2-5: Spain, Heart Defect Correction, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 2-6: Spain, Cardiac Device Implantation, Procedure Volumes Forecast, by Device Type, 2008-2013
Exhibit 2-7: Spain, Heart and Heart-Lung Transplantation, Procedure Volumes Forecast, 2008-2013

3. GENERAL SURGICAL PROCEDURES

3.1 Adrenalectomy
3.2 Appendectomy
3.3 Breast Procedures
	3.3.1 Augmentation and Reduction Mammoplasty
	3.3.2 Biopsy
		3.3.2.1 Surgical Biopsy
		3.3.2.2 Needle Biopsy
		3.3.2.3 Lumpectomy
	3.3.3 Mastectomy
		3.3.3.1 Prophylactic Mastectomy
		3.3.3.2 Simple Mastectomy
		3.3.3.3 Radical and Modified Radical Mastectomy
3.4 Cholecystectomy
3.5 Sophagogastric and Gastroduodenal Procedures
	3.5.1 Bariatric Surgery
	3.5.2 Esophagogastric Fundoplasty
	3.5.3 Peptic Ulcer Repair
3.6 Inguinal Herniorrhaphy
3.7 Colectomy
3.8 Liver Biopsy
3.9 Splenectomy

Exhibit 3-1: Spain, Open and Laparoscopic Adrenalectomy, Procedure Volumes Forecast, 2008-2013
Exhibit 3-2: Spain, Open and Laparoscopic Appendectomy, Procedure Volumes Forecast, 2008-2013
Exhibit 3-3: Spain, Breast Surgery, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 3-4: Spain, Open and Laparoscopic Cholecystectomy, Procedure Volumes Forecast, 2008-2013
Exhibit 3-5: Spain, Esophagogastric and Gastroduodenal Surgery, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 3-6: Spain, Open and Laparoscopic Inguinal Herniorrhaphy, Procedure Volumes Forecast, 2008-2013
Exhibit 3-7: Spain, Open and Laparoscopic Colectomy, Procedure Volumes Forecast, 2008-2013
Exhibit 3-8: Spain, Open and Laparoscopic Liver Biopsy and Tumor Excision, Procedure Volumes Forecast, 2008-2013
Exhibit 3-9: Spain, Open and Laparoscopic Splenectomy, Procedure Volumes Forecast, 2008-2013

4. NEUROSURGICAL PROCEDURES

4.1 Cerebral Aneurysms
4.2 Brain Tumors
4.3 Head Trauma
4.4 Hydrocephalus
	4.4.1 Intracranial Pressure Monitoring
	4.4.2 Cerebrospinal Fluid Shunting and Drainage
4.5 Stereotaxis

Exhibit 4-1: Spain, Intracranial Pressure Monitoring, Procedure Volumes Forecast, 2008-2013
Exhibit 4-2: Spain, Cerebrospinal Fluid Shunting, Procedure Volumes Forecast, 2008-2013
Exhibit 4-3: Spain, Stereotaxis, Procedure Volumes Forecast, 2008-2013

5. OBSTETRIC/GYNECOLOGIC SURGICAL PROCEDURES

5.1 Cesarean Section
5.2 Dilation and Curettage
5.3 Hysterectomy
	5.3.1 Minimally Invasive Hysterectomy
5.4 Hysteroscopy
	5.4.1 Endometrial Ablation
	5.4.2 Exploration and Adhesiolysis
	5.4.3 Myomectomy
5.5 Oophorectomy
5.6 Salpingectomy
5.7 Tubal Ligation

Exhibit 5-1: Spain, Cesarean Section Delivery, Procedure Volumes Forecast, 2008-2013
Exhibit 5-2: Spain, Dilation and Curettage, Procedure Volumes Forecast, 2008-2013
Exhibit 5-3: Spain, Open and Laparoscopic Hysterectomy, Procedure Volumes Forecast, 2008-2013
Exhibit 5-4: Spain, Endometrial Ablation, Procedure Volumes Forecast, 2008-2013
Exhibit 5-5: Spain, Open and Laparoscopic Exploration and Adhesiolysis, Procedure Volumes Forecast, 2008-2013
Exhibit 5-6: Spain, Open and Laparoscopic Myomectomy, Procedure Volumes Forecast, 2008-2013
Exhibit 5-7: Spain, Open and Laparoscopic Oophorectomy, Procedure Volumes Forecast, 2008-2013
Exhibit 5-8: Spain, Open and Laparoscopic Salpingectomy, Procedure Volumes Forecast, 2008-2013
Exhibit 5-9: Spain, Tubal Ligation, Procedure Volumes Forecast, 2008-2013

6. OPHTHALMIC SURGICAL PROCEDURES

6.1 Cataract Surgery and Intraocular Lens Implantation
6.2 Refractive Surgery
	6.2.1 Astigmatic, Hexagonal, and Radial Keratotomy
	6.2.2 Photorefractive Keratotomy
	6.2.3 Automated Lamellar Keratoplasty
	6.2.4 Corneal Ring Implantation
	6.2.5 Corneal Transplantation
	6.2.6 Laser-Assisted In Situ Keratomileusis
	6.2.7 Laser Epithelial Keratomileusis
6.3 Strabismus Correction

Exhibit 6-1: Spain, Cataract Surgery and Intraocular Lens Implantation, Procedure Volumes Forecast, 2008-2013
Exhibit 6-2: Spain, Refractive Surgery, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 6-3: Spain, Strabismus Correction, Procedure Volumes Forecast, 2008-2013

7. ORTHOPEDIC/ARTHROSCOPIC SURGICAL PROCEDURES

7.1 Fracture Repair
7.2 Joint Replacement
	7.2.1 Hip Replacement
	7.2.2 Knee Replacement
	7.2.3 Shoulder Replacement
	7.2.4 Small Joint Replacement
7.3 Arthroscopy
	7.3.1 Articular Cartilage Repair
	7.3.2 Ligament Repair
		7.3.2.1 Acromioclavicular Joint Resection
		7.3.2.2 Anterior Cruciate Ligament Reconstruction
		7.3.2.3 Posterior Cruciate Ligament Reconstruction
	7.3.3 Loose Body Removal
	7.3.4 Meniscal Repair
	7.3.5 Tendon Repair
		7.3.5.1 Carpal Tunnel Release
		7.3.5.2 Rotator Cuff Repair

Exhibit 7-1: Spain, Fracture Management, Procedure Volumes Forecast, 2008-2013
Exhibit 7-2: Spain, Hip Replacement, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 7-3: Spain, Knee Replacement, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 7-4: Spain, Shoulder Replacement, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 7-5: Spain, Small Joint Replacement, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 7-6: Spain, Joint Replacement, Combined Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 7-7: Spain, Ligament Repair, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 7-8: Spain, Loose Body Removal, Procedure Volumes Forecast, 2008-2013
Exhibit 7-9: Spain, Meniscal Repair, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 7-10: Spain, Tendon Repair, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 7-11: Spain, Arthroscopic Surgery, Combined Procedure Volumes Forecast, by Type, 2008-2013

8. OTORHINOLARYNGOLOGIC SURGICAL PROCEDURES

8.1 Adenoidectomy/Tonsillectomy
8.2 Myringotomy with Tympanostomy Tube Replacement
8.3 Rhinoplasty
8.4 Septoplasty
8.5 Tracheotomy

Exhibit 8-1: Spain, Otorhinolaryngologic Surgery, Procedure Volumes Forecast, by Type, 2008-2013

9. SPINE SURGERY

9.1 Total Disc Replacement
9.2 Disc and Bone Removal
	9.2.1 Discectomy
	9.2.2 Laminectomy and Laminotomy
9.3. Spinal Fusion
	9.3.1 Anterior Lumbar Interbody Fusion
	9.3.2 Posterior Lumbar Interbody Fusion
	9.3.3 Instrumented Fusion
	9.3.4 Thoracic Fusion
	9.3.5 Cervical Fusion
	9.3.6 Minimally Invasive Spinal Fixation

Exhibit 9-1: Spain, Total Disc Replacement, Procedure Volumes Forecast, 2008-2013
Exhibit 9-2: Spain, Disc and Bone Removal, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 9-3: Spain, Lumbar Fusion, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 9-4: Spain, Thoracic Fusion, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 9-5: Spain, Cervical Fusion, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 9-6: Spain, Minimally Invasive Spinal Fixation, Procedure Volumes Forecast, 2008-2013

10. UROLOGIC SURGICAL PROCEDURES

10.1 Bladder Neck Hypermobility and Urinary Incontinence
10.2 Nephrectomy and Kidney Transplantation
10.3 Prostate Procedures
	10.3.1 Prostatectomy
		10.3.1.1 Radical Prostatectomy
		10.3.1.2 Transurethral Resection of the Prostate
	10.3.2 Minimally Invasive Benign Prostatic Hyperplasia Therapy
	10.3.3 Prostatic Urethral Stent Placement
10.4 Stone and Obstruction Removal

Exhibit 10-1: Spain, Bladder Neck Hypermobility Correction, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 10-2: Spain, Intrinsic Sphincter Deficiency Correction, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 10-3: Spain, Nephrectomy and Kidney Transplantation, Procedure Volumes Forecast, 2008-2013
Exhibit 10-4: Spain, Prostate Disease/Disorder Management, Procedure Volumes Forecast, by Type, 2008-2013
Exhibit 10-5: Spain, Kidney Stone Management, Procedure Volumes Forecast, by Type, 2008-2013


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