$4,850.00
This report presents an overview of selected medical specialties and the number of surgical procedures performed for selected diseases/disorders in the EU country of France.
France, with a population of more than 65.9 million, has one of the highest levels of healthcare spending in Europe, and represents the leader among the European Union (EU) countries of France, Germany, Italy, Spain, and the United Kingdom in terms of healthcare spending as a percentage of gross domestic product (GDP), with approximately 11.6% of the country’s GDP spent on healthcare in 2011.
This report presents an overview of selected medical specialties and the number of surgical procedures performed for selected diseases/disorders in the EU country of France.
1. EUROPEAN HEALTHCARE OVERVIEW…………………………………………… 1-1
1.1 Healthcare Spending ………………………………………………………………. 1-2
1.2 Healthcare Facilities and Personnel ………………………………………….. 1-5
1.3 Reimbursement Structures………………………………………………………. 1-6
1.4 France, National Healthcare Profile…………………………………………. 1-11
1.4.1 Healthcare Organization and Reform ………………………… 1-12
1.4.2 Hospital Services……………………………………………………. 1-16
1.4.3 Medical Device Reimbursement……………………………….. 1-18
Exhibit 1-1: European Healthcare Expenditures as a Percentage of Gross
Domestic Product, Selected Countries, 2005-2011……………………… 1-4
Exhibit 1-2: European Union Population Statistics Comparison for
the Years 2010 and 2020 ………………………………………………………… 1-7
Exhibit 1-3: European Union, Medical Devices Risk Classification System…….. 1-10
Exhibit 1-4: 2010, France, Organizational Structure of the Healthcare System.. 1-13
Exhibit 1-5: 2010, France, Healthcare Funding System ………………………………. 1-14
Exhibit 1-6: France, Selected National Healthcare Statistics………………………… 1-20
2. CARDIOVASCULAR/PERIPHERAL VASCULAR
SURGICAL PROCEDURES ……………………………………………………………… 2-1
2.1 Arrhythmia …………………………………………………………………………….. 2-2
2.1.1 Atrial Fibrillation……………………………………………………….. 2-2
2.1.2 Supraventricular Tachycardia…………………………………….. 2-3
2.1.3 Ventricular Fibrillation ……………………………………………….. 2-4
2.1.4 Ventricular Tachycardia…………………………………………….. 2-4
2.2 Circulatory Disorders ………………………………………………………………. 2-4
2.2.1 Coronary Artery Disease …………………………………………… 2-5
2.2.2 Myocardial Infarction ………………………………………………… 2-5
2.2.3 Angina Pectoris ……………………………………………………….. 2-6
2.2.4 Aortic Aneurysm ………………………………………………………. 2-6
2.2.5 Atherosclerosis………………………………………………………… 2-8
2.2.6 Hypercholesterolemia……………………………………………….. 2-9
2.2.7 Hypertension …………………………………………………………. 2-10
2.2.8 Venous Thromboembolism: Deep Vein Thrombosis
and Pulmonary Embolism………………………………………… 2-10
2.3 Myocardial Disorders…………………………………………………………….. 2-11
2.3.1 Congenital Heart Defects ………………………………………… 2-11
2.3.2 Heart Failure………………………………………………………….. 2-12
2.3.3 Rheumatic Heart Disease………………………………………… 2-13
2.3.4 Valvular Heart Disease……………………………………………. 2-13
2.4 Aneurysm Repair………………………………………………………………….. 2-16
2.5 Coronary Artery Disease Treatment ………………………………………… 2-19
2.5.1 Coronary Artery Bypass Graft Surgery ………………………. 2-21
2.5.1.1 Less Invasive Coronary Artery Bypass
Graft Techniques……………………………………… 2-22
2.5.2 Percutaneous Transluminal Coronary Angioplasty/
Coronary Stenting ………………………………………………….. 2-26
2.5.3 Transmyocardial Revascularization…………………………… 2-34
2.5.4 Atherectomy ………………………………………………………….. 2-37
2.5.5 Thrombectomy and Thrombolysis …………………………….. 2-40
2.6 Peripheral Artery Disease and Treatment ………………………………… 2-42
2.6.1 Femoropopliteal Bypass………………………………………….. 2-45
2.6.2 Percutaneous Peripheral Revascularization Techniques 2-46
2.6.2.1 Percutaneous Transluminal Angioplasty ……… 2-47
2.6.2.2 Peripheral Atherectomy…………………………….. 2-49
2.6.2.3 Peripheral Femoropopliteal Stenting …………… 2-49
2.7 Heart Defect Repair………………………………………………………………. 2-51
2.7.1 Congenital Heart Defect Repair………………………………… 2-51
2.7.2 Heart Valve Repair and Replacement ……………………….. 2-53
2.8 Cardiac Device Implantation…………………………………………………… 2-57
2.8.1 Cardiac Resynchronization Therapy …………………………. 2-57
2.8.2 Pacemakers ………………………………………………………….. 2-58
2.8.3 Implantable Cardioverter Defibrillators ………………………. 2-58
2.8.4 Ventricular Assist Devices ……………………………………….. 2-60
Exhibit 2-1: France, Aneurysm Repair, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 2-20
Exhibit 2-2: France, Coronary Artery Bypass Graft Surgery,
Procedure Volumes Forecast, 2011-2018 ………………………………… 2-27
Exhibit 2-3: Major Milestones in the Development of Percutaneous
Coronary Intervention ……………………………………………………………. 2-28
Exhibit 2-4: France, Percutaneous Coronary Interventions/Stenting,
Procedure Volumes Forecast, 2011-2018 ………………………………… 2-35
Exhibit 2-5: France, Transmyocardial Revascularization,
Procedure Volumes Forecast, 2011-2018 ………………………………… 2-38
Exhibit 2-6: France, Atherectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 2-41
Exhibit 2-7: France, Thrombectomy and Thrombolysis,
Procedure Volumes Forecast, 2011-2018 ………………………………… 2-43
Exhibit 2-8: France, Peripheral Artery Disease Treatment,
Procedure Volumes Forecast, 2011-2018 ………………………………… 2-52
Exhibit 2-9: France, Heart Defect Repair, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 2-56
Exhibit 2-10: France, Cardiac Device Implantation,
Procedure Volumes Forecast, 2011-2018 ………………………………… 2-62
3. COSMETIC SURGICAL PROCEDURES ……………………………………………. 3-1
3.1 Abdominoplasty ……………………………………………………………………… 3-2
3.2 Blepharoplasty……………………………………………………………………….. 3-5
3.3 Breast Augmentation ………………………………………………………………. 3-6
3.4 Breast Reduction ……………………………………………………………………. 3-9
3.5 Liposuction ………………………………………………………………………….. 3-12
3.6 Mastopexy …………………………………………………………………………… 3-16
3.7 Rhinoplasty………………………………………………………………………….. 3-16
3.8 Rhytidectomy……………………………………………………………………….. 3-19
3.9 Other Cosmetic Surgical Procedures ………………………………………. 3-23
3.10 Combined Cosmetic Surgical Procedures ………………………………… 3-23
Exhibit 3-1: France, Abdominoplasty, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………….. 3-4
Exhibit 3-2: France, Blepharoplasty, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………….. 3-7
Exhibit 3-3: France, Breast Augmentation, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 3-10
Exhibit 3-4: France, Breast Reduction Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 3-13
Exhibit 3-5: France, Liposuction, Procedure Volumes Forecast, 2011-2018…… 3-15
Exhibit 3-6: France, Mastopexy, Procedure Volumes Forecast, 2011-2018……. 3-17
Exhibit 3-7: France, Rhinoplasty, Procedure Volumes Forecast, 2011-2018 ….. 3-20
Exhibit 3-8: France, Rhytidectomy, Procedure Volumes Forecast, 2011-2018 .. 3-22
Exhibit 3-9: France, Other Cosmetic Surgical Procedures,
Procedure Volumes Forecast, 2011-2018 ………………………………… 3-24
Exhibit 3-10: France and Europe, Cosmetic Surgery,
Comparative Procedure Volumes Forecast, 2011-2018……………… 3-26
4. GENERAL SURGICAL PROCEDURES……………………………………………… 4-1
4.1 Adrenalectomy……………………………………………………………………….. 4-1
4.2 Appendectomy……………………………………………………………………….. 4-2
4.3 Bariatric Surgery…………………………………………………………………….. 4-5
4.4 Cholecystectomy ………………………………………………………………….. 4-10
4.5 Colectomy …………………………………………………………………………… 4-13
4.6 Esophagogastric Fundoplasty ………………………………………………… 4-16
4.7 Hemorrhoidectomy and Other Hemorrhoid Procedures ……………… 4-19
4.8 Inguinal Herniorrhaphy ………………………………………………………….. 4-22
4.9 Liver Biopsy…………………………………………………………………………. 4-26
Exhibit 4-1: France, Adrenalectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………….. 4-3
Exhibit 4-2: France, Appendectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………….. 4-6
Exhibit 4-3: France, Bariatric Surgery, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 4-11
Exhibit 4-4: France, Cholecystectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 4-14
Exhibit 4-5: France, Colectomy, Procedure Volumes Forecast, 2011-2018 ……. 4-17
Exhibit 4-6: France, Esophagogastric Fundoplasty,
Procedure Volumes Forecast, 2011-2018 ………………………………… 4-20
Exhibit 4-7: France, Hemorrhoidectomy and Other Hemorrhoid Treatments,
Procedure Volumes Forecast, 2011-2018 ………………………………… 4-23
Exhibit 4-8: France, Inguinal Herniorrhaphy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 4-27
Exhibit 4-9: France, Liver Biopsy, Procedure Volumes Forecast, 2011-2018 …. 4-30
5. MAJOR ORGAN TRANSPLANTATION……………………………………………… 5-1
5.1 Heart Transplantation ……………………………………………………………… 5-2
5.2 Kidney Transplantation……………………………………………………………. 5-2
5.3 Liver Transplantation ………………………………………………………………. 5-3
5.4 Lung Transplantation………………………………………………………………. 5-3
5.5 Pancreas Transplantation………………………………………………………… 5-4
5.6 Small Bowel Transplantation ……………………………………………………. 5-4
5.7 Immunosuppressive Strategies ………………………………………………… 5-5
5.8 Organ Procurement and Donor Shortage…………………………………… 5-6
5.9 Organ Transplantation, Procedure Volumes …………………………….. 5-12
Exhibit 5-1: European Action Plan on Organ Donation and Transplantation
(2009-2015)…………………………………………………………………………… 5-8
Exhibit 5-2: France, Patients Awaiting Organ Transplant, 2006-2011 ……………. 5-10
Exhibit 5-3: France, Analysis of Organ Transplants, 2000-2011 …………………… 5-11
Exhibit 5-4: France, Major Organ Transplantation,
Procedure Volumes Forecast, 2011-2018 ………………………………… 5-14
6. NEUROSURGICAL PROCEDURES ………………………………………………….. 6-1
6.1 The Brain………………………………………………………………………………. 6-1
6.1.1 The Cerebrum …………………………………………………………. 6-1
6.1.2 The Cerebellum……………………………………………………….. 6-2
6.1.3 The Brainstem …………………………………………………………. 6-2
6.1.4 The Meninges………………………………………………………….. 6-4
6.1.5 The Ventricular System …………………………………………….. 6-4
6.1.6 Cerebrospinal Fluid ………………………………………………….. 6-7
6.1.7 The Hypothalamus …………………………………………………… 6-7
6.1.8 The Pineal Gland……………………………………………………… 6-7
6.1.9 The Pituitary Gland…………………………………………………… 6-7
6.2 Selected Disorders of the Central and
Peripheral Nervous Systems ……………………………………………………. 6-8
6.2.1 Hydrocephalus ………………………………………………………… 6-8
6.2.2 Movement, Seizure, and Tremor Disorders………………… 6-10
6.2.2.1 Alzheimer’s Disease…………………………………. 6-10
6.2.2.2 Epilepsy………………………………………………….. 6-12
6.2.2.3 Multiple Sclerosis …………………………………….. 6-13
6.2.2.4 Parkinson’s Disease…………………………………. 6-15
6.2.2.5 Treatment Options……………………………………. 6-15
6.2.2.5.1 Deep Brain Stimulation ………….. 6-15
6.2.2.5.2 Stereotactic Radiosurgery………. 6-16
6.2.3 Traumatic Brain Injury …………………………………………….. 6-17
6.3 The Cerebrovascular System and Selected Disorders ……………….. 6-20
6.3.1 The Arterial System………………………………………………… 6-22
6.3.2 The Venous System ……………………………………………….. 6-23
6.3.3 Aneurysm ……………………………………………………………… 6-24
6.3.4 Arteriovenous Malformation……………………………………… 6-26
6.3.5 Stroke…………………………………………………………………… 6-29
Exhibit 6-1: Structural Relationship between the Cerebrum, Cerebellum,
and Brainstem ……………………………………………………………………….. 6-3
Exhibit 6-2: Structure of the Meninges ……………………………………………………….. 6-5
Exhibit 6-3: Ventricles of the Brain …………………………………………………………….. 6-6
Exhibit 6-4: France, Ventriculostomy and Ventricular Shunting,
Procedure Volumes Forecast, 2011-2018 ………………………………… 6-11
Exhibit 6-5: France, Deep Brain Stimulation and Stereotactic Radiosurgery,
Procedure Volumes Forecast, 2011-2018 ………………………………… 6-18
Exhibit 6-6: France, Evacuation of Subdural Hematoma,
Procedure Volumes Forecast, 2011-2018 ………………………………… 6-21
Exhibit 6-7: France, Cerebral Aneurysm Clipping,
Procedure Volumes Forecast, 2011-2018 ………………………………… 6-27
Exhibit 6-8: France, Arteriovenous Malformation Embolization,
Procedure Volumes Forecast, 2011-2018 ………………………………… 6-30
Exhibit 6-9: France, Carotid Endarterectomy and Carotid Artery Stenting,
Procedure Volumes Forecast, 2011-2018 ………………………………… 6-33
7. OBSTETRIC/GYNECOLOGIC SURGICAL PROCEDURES………………….. 7-1
7.1 Cesarean Section …………………………………………………………………… 7-1
7.2 Dilation and Curettage…………………………………………………………….. 7-3
7.3 Hysterectomy ………………………………………………………………………… 7-7
7.4 Hysteroscopy…………………………………………………………………………. 7-9
7.4.1 Endometrial Ablation ………………………………………………. 7-11
7.4.2 Endometrial Biopsy ………………………………………………… 7-14
7.4.3 Myomectomy…………………………………………………………. 7-14
7.5 Oophorectomy……………………………………………………………………… 7-19
7.6 Salpingo-Oophorectomy………………………………………………………… 7-21
7.7 Tubal Ligation………………………………………………………………………. 7-23
Exhibit 7-1: France, Cesarean Section, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………….. 7-4
Exhibit 7-2: France, Dilation and Curettage, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………….. 7-6
Exhibit 7-3: France, Hysterectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 7-10
Exhibit 7-4: France, Endometrial Ablation, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 7-15
Exhibit 7-5: France, Endometrial Biopsy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 7-16
Exhibit 7-6: France, Myomectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 7-20
Exhibit 7-7: France, Oophorectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 7-22
Exhibit 7-8: France, Salpingo-Oophorectomy,
Procedure Volumes Forecast, 2011-2018 ………………………………… 7-24
Exhibit 7-9: France, Tubal Ligation, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 7-26
8. OPHTHALMIC SURGICAL PROCEDURES ……………………………………….. 8-1
8.1 Age-Related Macular Degeneration and Diabetic Retinopathy ……… 8-1
8.2 Cataract Surgery and Intraocular Implantation ……………………………. 8-6
8.3 Glaucoma ……………………………………………………………………………. 8-10
8.4 Refractive Surgery………………………………………………………………… 8-15
8.5 Strabismus Correction …………………………………………………………… 8-21
8.6 Vitrectomy …………………………………………………………………………… 8-25
Exhibit 8-1: France, Treatment for Age-Related Macular Degeneration and
Diabetic Retinopathy, Procedure Volumes Forecast, 2011-2018 …… 8-7
Exhibit 8-2: France, Cataract Surgery and Intraocular Implantation,
Procedure Volumes Forecast, 2011-2018 ………………………………… 8-11
Exhibit 8-3: France, Glaucoma Surgery, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 8-16
Exhibit 8-4: France, Refractive Surgery, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 8-22
Exhibit 8-5: France, Strabismus Correction, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 8-26
Exhibit 8-6: France, Vitrectomy, Procedure Volumes Forecast, 2011-2018 ……. 8-28
9. ORTHOPEDIC/SPINE SURGICAL PROCEDURES……………………………… 9-1
9.1 Fractures and Fracture Management ………………………………………… 9-1
9.1.1 Types of Fractures …………………………………………………… 9-3
9.1.2 Arthritis and Fractures ………………………………………………. 9-4
9.1.3 Internal Fixation of Fractures……………………………………… 9-5
9.1.4 External Fixation of Fractures…………………………………….. 9-7
9.2 The Spine and Spine Surgery/Spinal Instrumentation ………………….. 9-9
9.2.1 The Vertebral Column ………………………………………………. 9-9
9.2.1.1 Disorders of the Vertebral Column ……………… 9-11
9.2.1.1.1 Low Back Pain ……………………… 9-11
9.2.1.1.2 Scoliosis………………………………. 9-12
9.2.2 Anterior Cervical Plates…………………………………………… 9-13
9.2.3 Interbody Fusion Devices………………………………………… 9-13
9.2.4 Pedicle Screws………………………………………………………. 9-15
9.2.5 Laminectomy…………………………………………………………. 9-16
9.2.6 Microdiscectomy…………………………………………………….. 9-17
9.2.7 Balloon Kyphoplasty……………………………………………….. 9-18
9.2.8 Vertebroplasty ……………………………………………………….. 9-18
9.2.9 Spinal Fusion…………………………………………………………. 9-19
9.2.10 Prosthetic Intervertebral Disc Replacement ……………….. 9-21
9.2.11 Instrumented Spinal Deformity Correction………………….. 9-22
9.3 The Joints and Associated Diseases/Disorders and Injuries ……….. 9-24
9.3.1 Fibrous/Immoveable Joints………………………………………. 9-30
9.3.2 Cartilaginous Joints ………………………………………………… 9-30
9.3.3 Synovial Joints ………………………………………………………. 9-31
9.3.4 Joint Replacement………………………………………………….. 9-32
9.3.4.1 Total Hip Replacement……………………………… 9-32
9.3.4.2 Total Knee Replacement…………………………… 9-37
9.3.4.3 Total Shoulder Replacement ……………………… 9-41
9.3.4.3.1 Shoulder Hemiarthroplasty …….. 9-41
9.3.4.3.2 Revision Shoulder Arthroplasty.. 9-42
9.3.5 Arthroscopy …………………………………………………………… 9-43
9.3.5.1 Anterior Cruciate Ligament Repair ……………… 9-45
9.3.5.2 Carpal Tunnel Release……………………………… 9-46
9.3.5.3 Lavage and Debridement of the Knee…………. 9-48
9.3.5.4 Meniscal and Articular Cartilage Repair ………. 9-49
9.3.5.5 Rotator Cuff Repair ………………………………….. 9-50
Exhibit 9-1: France, Internal Fixation/Fracture Repair of the Femur
and Tibia/Fibula, Procedure Volumes Forecast, 2011-2018………….. 9-8
Exhibit 9-2: France, External Fixation, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 9-10
Exhibit 9-3: Classification of Anterior Cervical Plates ………………………………….. 9-14
Exhibit 9-4: France, Spine Surgery, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 9-25
Exhibit 9-5: Types of Synovial Joints………………………………………………………… 9-33
Exhibit 9-6: Illustrated Schematic of Total Hip Replacement Using
a Monoblock or Modular Femoral Stem……………………………………. 9-36
Exhibit 9-7: France, Total Hip Replacement, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 9-38
Exhibit 9-8: France, Total and Unicompartmental Knee Replacement,
Procedure Volumes Forecast, 2011-2018 ………………………………… 9-40
Exhibit 9-9: France, Total Shoulder Replacement,
Procedure Volumes Forecast, 2011-2018 ………………………………… 9-44
Exhibit 9-10: France, Selected Arthroscopic Surgery,
Procedure Volumes Forecast, 2011-2018 ………………………………… 9-52
10. OTORHINOLARYNGOLOGIC SURGICAL PROCEDURES………………… 10-1
10.1 Adenoidectomy…………………………………………………………………….. 10-1
10.2 Mastoidectomy …………………………………………………………………….. 10-3
10.3 Myringotomy and Tube Placement ………………………………………….. 10-5
10.4 Septoplasty………………………………………………………………………….. 10-7
10.5 Tonsillectomy ………………………………………………………………………. 10-9
10.6 Tracheostomy…………………………………………………………………….. 10-13
10.7 Combined Otorhinolaryngologic Surgical Procedures ………………. 10-17
Exhibit 10-1: France, Adenoidectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 10-4
Exhibit 10-2: France, Mastoidectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 10-6
Exhibit 10-3: France, Myringotomy and Tube Placement,
Procedure Volumes Forecast, 2011-2018 ………………………………… 10-8
Exhibit 10-4: France, Septoplasty, Procedure Volumes Forcast,
2011-2018 …………………………………………………………………………. 10-10
Exhibit 10-5: France, Tonsillectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………. 10-14
Exhibit 10-6: France, Tracheostomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………. 10-18
Exhibit 10-7: France and Europe, Otorhinolaryngologic Surgery,
Procedure Volumes Forecast, 2011-2018 ………………………………. 10-20
11. UROLOGIC SURGICAL PROCEDURES………………………………………….. 11-1
11.1 Benign Prostatic Hyperplasia …………………………………………………. 11-1
11.2 Kidney Stone Obstruction………………………………………………………. 11-5
11.3 Urinary Incontinence……………………………………………………………. 11-10
Exhibit 11-1: France, Benign Prostatic Hyperplasia Treatment,
Procedure Volumes Forecast, 2011-2018 ………………………………… 11-6
Exhibit 11-2: France, Kidney Stone Removal,
Procedure Volumes Forecast, 2011-2018 ………………………………. 11-11
Exhibit 11-3: France, Urinary Incontinence Treatment,
Procedure Volumes Forecast, 2011-2018 ………………………………. 11-16
Figure: France, Cosmetic Surgery, Combined Procedure Volumes Forecast, 2011-2018
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