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U.S. Surgical Procedure Volumes
Report #A607 - March 2009
448 Pages – 106 Exhibits

The number of surgical procedures performed in the United States (U.S.) is increasing, particularly those involving same-day/less invasive surgery and technological advances that help decrease a patient’s recovery time and hospital length of stay. For example, nonsurgical cosmetic procedures are increasing, and in some cases competing with traditional surgery; the recent growth in refractive surgery may be short-lived due to competition from implantable lenses and issues regarding Lasik procedures; recent trials show that men who had laparoscopic prostatectomies have a 40% greater risk of scarring than those who undergo open prostatectomy; and transurethral resection of the prostate is declining in favor of new drugs, laser treatments, and other technologies for prostatic ablation. In addition, technological advances and augmentation have improved many common diagnostic procedures, such as mammography––in 2008, the Journal of the American Medical Association reported that 28% more cancers are found when ultrasound is added to this screening.

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.

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U.S. Surgical Procedure Volumes

A607

 March 2009

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Methodology

Reports are produced exclusively by Medtech Insight, through extensive primary and secondary research among the clinicians, researchers, and competitors in the marketplace, and draw upon the industry expertise of a network of industry insiders. Medtech Insight exhaustively corroborates the data as a baseline for completing forward-looking analysis and providing insight into product, technology and market evolution.

 

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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