EXECUTIVE SUMMARY …………………………………………………………………………. ES-1
i. Methodology……………………………………………………………………….. ES-2

1. CARDIOVASCULAR/THORACIC SURGICAL PROCEDURES …………….. 1-1
1.1 Circulatory Vascular Disorders …………………………………………………. 1-2
1.1.1 Atherosclerosis………………………………………………………… 1-2
1.1.2 Coronary Heart Disease……………………………………………. 1-3
1.1.3 Angina Pectoris ……………………………………………………….. 1-4
1.1.4 Acute Myocardial Infarction ……………………………………….. 1-6
1.1.5 Peripheral Vascular Disease ……………………………………… 1-7
1.1.5.1 Aortic Aneurysm ………………………………………… 1-8
1.1.5.2 Lower Extremity Arterial Occlusion……………….. 1-9
1.1.5.3 Deep Vein Thrombosis and Pulmonary Embolism………………………………………………… 1-10
1.2 Myocardial Disorders…………………………………………………………….. 1-13
1.2.1 Congenital Heart Defects ………………………………………… 1-13
1.2.2 Heart Valve Disorders …………………………………………….. 1-15
1.2.3 Heart Failure………………………………………………………….. 1-18
1.3 Cardiac Rhythm Disorders …………………………………………………….. 1-22
1.3.1 Bradycardia …………………………………………………………… 1-23
1.3.2 Supraventricular Tachycardia…………………………………… 1-23
1.3.2.1 Atrial Fibrillation……………………………………….. 1-24
1.3.3 Ventricular Tachycardia…………………………………………… 1-26
1.3.3.1 Ventricular Fibrillation……………………………….. 1-27
1.4 Therapeutic Management of Circulatory Disorders ……………………. 1-28
1.4.1 Coronary Artery Disease Treatment………………………….. 1-28
1.4.1.1 Coronary Artery Bypass Graft Surgery………… 1-29
1.4.1.1.1 Less Invasive Coronary Artery Bypass Graft Surgery…………….. 1-31
1.4.1.1.2 Patient Indications…………………. 1-35
1.4.1.1.3 Procedure Volumes ………………. 1-37
1.4.1.2 Percutaneous Coronary Interventions …………. 1-39
1.4.1.2.1 Percutaneous Transluminal Coronary Angioplasty and Stenting……………………………….. 1-41
1.4.1.2.1.1 Procedure Volumes …………… 1-47
1.4.1.2.2 Mechanical Atherectomy………… 1-52
1.4.1.2.2.1 Procedure Volumes …………… 1-55
1.4.1.2.3 Laser Coronary Atherectomy ….. 1-57
1.4.1.2.3.1 Procedure Volumes …………… 1-60
1.4.1.2.4 Mechanical Coronary Thrombectomy……………………… 1-60
1.4.1.2.4.1 Procedure Volumes …………… 1-63
1.4.1.3 Transmyocardial Laser Revascularization……. 1-64
1.4.1.3.1 Procedure Volumes ………………. 1-67
1.4.2 Peripheral Vascular Disease Treatment…………………….. 1-70
1.4.2.1 Aortic Aneurysm Treatment Regimens………… 1-71
1.4.2.1.1 Surgical Repair of Aortic Aneurysms…………………………… 1-71
1.4.2.1.2 Abdominal Aortic Aneurysm Repair/Endovascular Stent Grafting……………………….. 1-71
1.4.2.1.2.1 Endovascular Abdominal Aortic Aneurysm Repair Versus Open Surgery…………….. 1-73
1.4.2.1.3 Endovascular Thoracic Aortic Aneurysm Repair ………………….. 1-74
1.4.2.1.4 Procedure Volumes ………………. 1-75
1.4.2.2 Treatment of Lower Extremity Arterial Occlusions………………………………………………. 1-77
1.4.2.2.1 Bypass Graft Surgery for Lower Extremity Revascularization……. 1-79
1.4.2.2.1.1 Aortoiliofemoral Bypass Graft Surgery…………….. 1-80
1.4.2.2.1.2 Tibioperoneal Reconstruction…… 1-81
1.4.2.2.1.3 Femoropopliteal Bypass Surgery …. 1-81
1.4.2.2.1.4 Procedure Volumes ……………………………. 1-83
1.4.2.2.2 Percutaneous Transluminal Angioplasty ………………………….. 1-84
1.4.2.2.2.1 Procedure Volumes …………… 1-88
1.4.2.2.3 Lower Extremity Stenting ……….. 1-89
1.4.2.2.3.1 Iliac Artery Stenting ……………. 1-91
1.4.2.2.3.2 Femoropopliteal Artery Stenting…… 1-92
1.4.2.2.3.3 Infrapopliteal/Belowthe-Knee Stenting. 1-94
1.4.2.2.3.4 Other…………………………………… 1-95
1.4.2.2.3.4 Procedure Volumes …………… 1-96
1.4.2.2.4 Peripheral Mechanical Atherectomy…………………………. 1-99
1.4.2.2.4.1 Procedure Volumes …………. 1-102
1.4.2.2.5 Peripheral Excimer Laser Atherectomy……………………….. 1-103
1.4.2.2.5.1 Procedure Volumes …………. 1-105
1.4.2.2.6 Peripheral Mechanical Thrombectomy, Including AV Grafts and Fistulae…………. 1-106
1.4.2.2.6.1 Procedure Volumes …………. 1-109
1.5 Therapeutic Management of Myocardial Disorders ………………….. 1-110
1.5.1 Congenital Heart Defect Repair………………………………. 1-110
1.5.1.1 Procedure Volumes………………………………… 1-113
1.5.2 Treatment of Heart Valve Disorders ………………………… 1-114
1.5.2.1 Percutaneous Balloon Valvuloplasty …………. 1-114
1.5.2.1.1 Procedure Volumes …………….. 1-117
1.5.2.2 Heart Valve Repair and Replacement ……….. 1-120
1.5.2.2.1 Procedure Volumes …………….. 1-123
1.5.3 Ventricular Assist Devices for Late-Stage Heart Failure………………………………………………………… 1-124
1.5.3.1 Procedure Volumes………………………………… 1-130
1.6 Implantable Devices for Cardiac Rhythm Management…………….. 1-132
1.6.1 Cardiac Pacing Systems ……………………………………….. 1-134
1.6.1.1 Magnetic Resonance Imaging-Safe Pacemakers ………………………………………….. 1-137
1.6.1.2 Procedure Volumes………………………………… 1-137
1.6.2 Implantable Cardioverter Defibrillators …………………….. 1-138
1.6.2.1 Procedure Volumes………………………………… 1-142
1.6.3 Cardiac Resynchronization Therapy Systems…………… 1-144
1.6.3.1 Procedure Volumes………………………………… 1-147
1.7 Thoracic Surgery ………………………………………………………………… 1-149
1.7.1 Thoracotomy ……………………………………………………….. 1-149
1.7.2 Procedure Volumes………………………………………………. 1-152
1.7.3 Thoracoscopy………………………………………………………. 1-153
1.7.4 Procedure Volumes………………………………………………. 1-156

Exhibit 1-1: On-Pump and Off-Pump Coronary Artery Bypass Graft Surgery, Procedure Volumes Forecast, 2015-2021………………………………… 1-40
Exhibit 1-2: Percutaneous Transluminal Coronary Angioplasty/Stenting, Procedure Volumes Forecast, 2015-2021………………………………… 1-51
Exhibit 1-3: Mechanical Coronary Atherectomy, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 1-58
Exhibit 1-4: Laser Coronary Atherectomy, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 1-61
Exhibit 1-5: Mechanical Coronary Thrombectomy, Procedure Volumes Forecast, 2015-2021 …………………………………………………………….. 1-65
Exhibit 1-6: Transmyocardial Laser Revascularization, Procedure Volumes Forecast, 2015-2021 …………………………………………………………….. 1-69
Exhibit 1-7: Aortic Aneurysm Repair, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 1-78
Exhibit 1-8: Lower Extremity Surgical Bypass Grafting, Procedure Volumes Forecast, 2015-2021 …………………………………………………………….. 1-85
Exhibit 1-9: Percutaneous Transluminal Angioplasty,  US Surgical Procedure Volumes Procedure Volumes Forecast, 2015-2021………………………………… 1-90
Exhibit 1-10: Lower Extremity Stenting, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 1-98
Exhibit 1-11: Peripheral Mechanical Atherectomy, Procedure Volumes Forecast, 2015-2021 …………………………………………………………… 1-104
Exhibit 1-12: Peripheral Excimer Laser Atherectomy, Procedure Volumes Forecast, 2015-2021 …………………………………………………………… 1-107
Exhibit 1-13: Peripheral Mechanical Thrombectomy, Including AV Grafts and Fistulae, Procedure Volumes Forecast, 2015-2021………………….. 1-111
Exhibit 1-14: Clinical Presentation and Share of Common Congenital Heart Defects……………………………………………………………………… 1-112
Exhibit 1-15: Congenital Heart Defect Repair, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………. 1-115
Exhibit 1-16: Percutaneous Balloon Valvuloplasty, Procedure Volumes Forecast, 2015-2021 …………………………………………………………… 1-119
Exhibit 1-17: Heart Valve Repair and Replacement, Procedure Volumes Forecast, 2015-2021 …………………………………………………………… 1-125
Exhibit 1-18: Ventricular Assist Device Placement, Procedure Volumes Forecast, 2015-2021 …………………………………………………………… 1-133
Exhibit 1-19: Pacemaker Implantation, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………. 1-139
Exhibit 1-20: Implantable Cardioverter Defibrillator Placement, Procedure Volumes Forecast, 2015-2021 ……………………………………………… 1-145
Exhibit 1-21: Cardiac Resynchronization Therapy Device Placement, Procedure Volumes Forecast, 2015-2021………………………………. 1-150
Exhibit 1-22: Thoracotomy, Procedure Volumes Forecast, 2015-2021 ………….. 1-154
Exhibit 1-23: Thoracoscopy, Procedure Volumes Forecast, 2015-2021…………. 1-157

2. COSMETIC SURGICAL PROCEDURES ……………………………………………. 2-1
2.1 Abdominoplasty……………………………………………………………………… 2-2
2.1.1 Procedure Volumes………………………………………………….. 2-3
2.2 Augmentation and Reduction Mammoplasty ………………………………. 2-4
2.2.1 Procedure Volumes………………………………………………….. 2-9
2.3 Blepharoplasty……………………………………………………………………… 2-10
2.3.1 Procedure Volumes………………………………………………… 2-13
2.4 Hair Transplantation ……………………………………………………………… 2-14
2.4.1 Procedure Volumes………………………………………………… 2-17
2.5 Liposuction ………………………………………………………………………….. 2-18
2.5.1 Procedure Volumes………………………………………………… 2-22
2.6 Rhytidectomy……………………………………………………………………….. 2-24
2.6.1 Procedure Volumes………………………………………………… 2-25
2.7 Trends in Cosmetic Surgery …………………………………………………… 2-26

Exhibit 2-1: Abdominoplasty, Procedure Volumes Forecast, 2015-2021………….. 2-5
Exhibit 2-2: Breast Augmentation and Reduction Mammoplasty, Procedure Volumes Forecast, 2015-2021………………………………… 2-11
Exhibit 2-3: Blepharoplasty, Procedure Volumes Forecast, 2015-2021 …………. 2-15
Exhibit 2-4: Hair Transplantation, Procedure Volumes Forecast, 2015-2021….. 2-19
Exhibit 2-5: Liposuction, Procedure Volumes Forecast, 2015-2021………………. 2-23
Exhibit 2-6: Rhytidectomy, Procedure Volumes Forecast, 2015-2021 …………… 2-27

3. GENERAL SURGICAL PROCEDURES……………………………………………… 3-1
3.1 Abdominal Adhesiolysis…………………………………………………………… 3-1
3.1.1 Procedure Volumes………………………………………………….. 3-5
3.2 Appendectomy……………………………………………………………………….. 3-8
3.2.1 Procedure Volumes………………………………………………….. 3-9
3.3 Bariatric Surgery…………………………………………………………………… 3-11
3.3.1 Procedure Volumes ………………………………………………………. 3-17
3.4 Cholecystectomy ………………………………………………………………….. 3-18
3.4.1 Procedure Volumes………………………………………………… 3-21
3.5 Esophagogastric Fundoplasty ………………………………………………… 3-22
3.5.1 Procedure Volumes………………………………………………… 3-25
3.6 Inguinal Herniorrhaphy ………………………………………………………….. 3-27
3.6.1 Procedure Volumes………………………………………………… 3-29
3.7 Large Intestine Procedures ……………………………………………………. 3-31
3.7.1 Colectomy and Sigmoidectomy ………………………………… 3-31
3.7.1.2 Procedure Volumes………………………………….. 3-34
3.7.2 Hemorrhoid Surgery ……………………………………………….. 3-35
3.7.2.1 Procedure Volumes………………………………….. 3-38
3.8 Liver Biopsy…………………………………………………………………………. 3-41
3.7.1 Procedure Volumes………………………………………………… 3-42

Exhibit 3-1: Abdominal Adhesiolysis, Procedure Volumes Forecast, 2015-2021 ……………………………………………………………………………..3-7
Exhibit 3-2: Appendectomy, Procedure Volumes Forecast, 2015-2021 ………….3-12
Exhibit 3-3: Bariatric/Gastric Bypass, Procedure Volumes Forecast, 2015-2021 ……………………………………………………………………………3-19
Exhibit 3-4: Cholecystectomy, Procedure Volumes Forecast, 2015-2021……….3-23
Exhibit 3-5: Esophagogastric Fundoplasty, Procedure Volumes Forecast, 2015-2021 ……………………………………………………………………………3-26
Exhibit 3-6: Inguinal Herniorrhaphy, Procedure Volumes Forecast, 2015-2021 ……………………………………………………………………………3-30
Exhibit 3-7: Colectomy and Sigmoidectomy, Procedure Volumes Forecast, 2015-2021 ……………………………………………………………………………3-36
Exhibit 3-8: Hemorrhoidectomy, Procedure Volumes Forecast, 2015-2021…….3-40
Exhibit 3-9: Liver Biopsy, Procedure Volumes Forecast, 2015-2021………………3-43

4. MAJOR ORGAN/STEM CELL/TISSUE TRANSPLANTATION ……………… 4-1
4.1 Organ Donor Shortage ……………………………………………………………. 4-1
4.2 Oversight and Monitoring ………………………………………………………… 4-6
4.3 Transplant Procedure Volumes ………………………………………………… 4-6
4.4 New Technology…………………………………………………………………….. 4-7
4.5 Organ Transplants and Immunosuppressive Strategies……………….. 4-7
4.6 Major Organ Transplantation………………………………………………….. 4-11
4.6.1 Heart Transplants…………………………………………………… 4-11
4.6.2 Heart-Lung Transplants…………………………………………… 4-12
4.6.3 Intestinal Transplants ……………………………………………… 4-12
4.6.4 Kidney Transplants…………………………………………………. 4-13
4.6.5 Kidney-Pancreas Transplants ………………………………….. 4-15
4.6.6 Liver Transplants……………………………………………………. 4-15
4.6.7 Lung Transplants……………………………………………………. 4-16
4.6.8 Pancreas Transplants……………………………………………… 4-18
4.6.9 Patient Survival ……………………………………………………… 4-19
4.6.10 Procedure Volumes……………………………………………….. 4-19
4.7 Bone Marrow and Stem Cell Transplantation ……………………………. 4-23
4.7.1 Non-Myeloablative Transplants ………………………………… 4-26
4.7.2 Syngeneic Transplants……………………………………………. 4-27
4.7.3 Allogeneic Transplants ……………………………………………. 4-27
4.7.4 Autologous Transplants…………………………………………… 4-27
4.7.5 Other Sources of Stem Cells ……………………………………. 4-28
4.7.6 Procedure Volumes………………………………………………… 4-28
4.8 Corneal Transplantation ………………………………………………………… 4-34
4.8.1 Procedure Volumes………………………………………………… 4-36

Exhibit 4-1: Patients Awaiting Organ Transplants, 2016 ……………………………….. 4-3
Exhibit 4-2: Major Organ Transplants, 2015………………………………………………… 4-8
Exhibit 4-3: 2015, Patient Survival Rates at 1 and 5 Years, by Transplanted Organ………………………………………………………….. 4-20
Exhibit 4-4: Cadaveric and Living Donor Organ Transplants, Historical Procedure Volumes, 2005-2015 ……………………………….. 4-21
Exhibit 4-5: Major Organ Transplantation, Procedure Volumes Forecast, by Type, 2015-2021………………………………………………………………. 4-24
Exhibit 4-6: 2015, Unrelated Bone Marrow Stem Cell Transplants, by Primary Diagnosis…………………………………………………………….. 4-30
Exhibit 4-7: Unrelated Bone Marrow Stem Cell Transplants, Historical Procedure Volumes, by Primary Diagnosis for Selected Years, 2005-2015 …………………………………………………………………………… 4-31
Exhibit 4-8: Unrelated Stem Cell Transplants, Historical Procedure Volumes, by Cell Source, 2005-2015 …………………………………………………….. 4-33
Exhibit 4-9: Unrelated Stem Cell Transplantation, Procedure Volumes Forecast, by Cell Source, 2015-2021 ………………………………………. 4-35
Exhibit 4-10: Corneal Transplantation, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 4-39

5. NEUROSURGICAL PROCEDURES ………………………………………………….. 5-1
5.1 Stroke…………………………………………………………………………………… 5-1
5.1.1 Hemorrhagic Stroke………………………………………………….. 5-1
5.1.2 Ischemic Stroke……………………………………………………….. 5-3
5.2 Cerebral Aneurysm…………………………………………………………………. 5-5
5.3 Arteriovenous Malformations……………………………………………………. 5-6
5.4 Tumors of the Brain and Central Nervous System ………………………. 5-7
5.5 Traumatic Brain Injury …………………………………………………………….. 5-9
5.6 Hydrocephalus and Increased Intracranial Pressure………………….. 5-11
5.7 Neurosurgical Procedures ……………………………………………………… 5-13
5.7.1 Cerebrospinal Fluid Shunting and Drainage……………….. 5-13
5.7.1.1 Procedure Volumes…………………………………. 5-14
5.7.2 Carotid Endarterectomy…………………………………………… 5-15
5.7.2.1 Procedure Volumes…………………………………. 5-17
5.7.3 Cerebral Aneurysm and Arteriovenous Malformation Surgical Clipping ……………………………………………………. 5-18
5.7.3.1 Procedure Volumes………………………………….. 5-21
5.7.4 Cerebral Aneurysm and Arteriovenous Malformation Embolization………………………………………………………….. 5-22
5.7.4.1 Procedure Volumes………………………………….. 5-24
5.7.5 Carotid Artery Stenting ……………………………………………. 5-25
5.7.5.1 Carotid Revascularization Endarterectomy versus Stenting Trial Results……………………… 5-27
5.7.5.2 Procedure Volumes………………………………….. 5-30
5.7.6 Intracranial Stenting………………………………………………… 5-33
5.7.6.1 Procedure Volumes………………………………….. 5-34

Exhibit 5-1: Cerebrospinal Fluid Shunting, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 5-16
Exhibit 5-2: Carotid Endarterectomy, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 5-19
Exhibit 5-3: Cerebral Aneurysm and Arteriovenous Malformation Surgical Clipping, Procedure Volumes Forecast, 2015-2021 ………………….. 5-23
Exhibit 5-4: Cerebral Aneurysm and Arteriovenous Malformation Embolization, Procedure Volumes Forecast, 2015-2021……………. 5-26
Exhibit 5-5: Carotid Artery Stenting, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 5-32
Exhibit 5-6: Intracranial Stenting, Procedure Volumes Forecast, 2015-2021 ….. 5-36

6. OBSTETRIC/GYNECOLOGIC SURGICAL PROCEDURES………………….. 6-1
6.1 Dysfunctional Uterine Bleeding…………………………………………………. 6-1
6.2 Gynecologic Procedures …………………………………………………………. 6-3
6.2.1 Dilation and Curettage………………………………………………. 6-3
6.2.1.1 Procedure Volumes……………………………………. 6-5
6.2.2 Hysterectomy ………………………………………………………….. 6-7
6.2.2.1 Minimally Invasive Techniques…………………….. 6-8
6.2.2.2 Procedure Volumes………………………………….. 6-10
6.2.3 Hysteroscopy…………………………………………………………. 6-11
6.2.3.1 Endometrial Ablation ………………………………… 6-14
6.2.3.2 Procedure Volumes………………………………….. 6-16
6.2.4 Myomectomy …………………………………………………………. 6-17
6.2.4.1 Procedure Volumes………………………………….. 6-19
6.2.5 Diagnostic Procedures for Infertility…………………………… 6-20
6.2.5.1 Hysterosonography, Hysterosalpingography, and Laparoscopy……………………………………… 6-22
6.2.5.2 Procedure Volumes………………………………….. 6-24
6.3 Female Sterilization ………………………………………………………………. 6-25
6.3.1 Tubal Ligation………………………………………………………… 6-27
6.3.1.1 Procedure Volumes………………………………….. 6-28
6.4 Obstetric Procedures…………………………………………………………….. 6-29
6.4.1 Live Births……………………………………………………………… 6-29
6.4.1.1 Procedure Volumes………………………………….. 6-29
6.4.2 Cesarean Section…………………………………………………… 6-34
6.4.2.1 Procedure Volumes………………………………….. 6-36

Exhibit 6-1: Dilation and Curettage, Procedure Volumes Forecast, 2015-2021 … 6-6
Exhibit 6-2: Hysterectomy, Procedure Volumes Forecast, 2015-2021 …………… 6-12
Exhibit 6-3: Hysteroscopy, Procedure Volumes Forecast, 2015-2021 …………… 6-18
Exhibit 6-4: Myomectomy, Procedure Volumes Forecast, 2015-2021……………. 6-21
Exhibit 6-5: Diagnostic Examinations for Infertility, Procedure Volumes Forecast, 2015-2021 …………………………………………………………….. 6-26
Exhibit 6-6: Tubal Ligation, Procedure Volumes Forecast, 2015-2021…………… 6-30
Exhibit 6-7: Live Births, Historical Procedure Volumes, 1995-2015……………….. 6-31
Exhibit 6-8: Live Births, Procedure Volumes Forecast, 2015-2021 ……………….. 6-33
Exhibit 6-9: Cesarean Section, Procedure Volumes Forecast, 2015-2021……… 6-37

7. OPHTHALMIC SURGICAL PROCEDURES ……………………………………….. 7-1
7.1 Age-Related Macular Degeneration ………………………………………….. 7-1
7.1.1 Anti-Angiogenic Therapy …………………………………………… 7-2
7.1.2 Verteporfin Photodynamic Therapy …………………………….. 7-3
7.1.3 Transpupillary Thermotherapy……………………………………. 7-4
7.1.4 Retinal Photocoagulation…………………………………………… 7-5
7.1.5 Other Therapies ………………………………………………………. 7-6
7.1.6 Procedure Volumes………………………………………………….. 7-7
7.2 Cataract Surgery ……………………………………………………………………. 7-7
7.2.1 Capsulotomy …………………………………………………………. 7-13
7.2.2 Procedure Volumes………………………………………………… 7-14
7.3 Diabetic Retinopathy …………………………………………………………….. 7-14
7.3.1 Procedure Volumes………………………………………………… 7-18
7.4 Glaucoma Surgery………………………………………………………………… 7-18
7.4.1 Procedure Volumes………………………………………………… 7-23
7.5 Refractive Surgery………………………………………………………………… 7-23
7.5.1 Laser-Based Vision Correction…………………………………. 7-25
7.5.1.1 Photorefractive Keratectomy ……………………… 7-26
7.5.1.2 Laser In Situ Keratomileusis………………………. 7-26
7.5.1.2.1 Laser Epithelial Keratomileusis.. 7-27
7.5.1.2.2 Custom Laser In Situ Keratomileusis ……………………… 7-28
7.5.1.2.3 Photoablative Inlay Laser In Situ Keratomileusis ……………. 7-28
7.5.1.3 Procedure Volumes………………………………….. 7-30
7.6 Strabismus Correction …………………………………………………………… 7-30
7.6.1 Procedure Volumes………………………………………………… 7-34
7.7 Vitrectomy …………………………………………………………………………… 7-34
7.7.1 Procedure Volumes………………………………………………… 7-36

Exhibit 7-1: Laser Therapy for Age-Related Macular Degeneration, Procedure Volumes Forecast, 2015-2021 …………………………………………………. 7-8
Exhibit 7-2: Cataract Surgery, Procedure Volumes Forecast, 2015-2021………. 7-15
Exhibit 7-3: Diabetic Retinopathy Laser Surgery, Procedure Volumes Forecast, 2015-2021 …………………………………………………………….. 7-19
Exhibit 7-4: Glaucoma Surgery, Procedure Volumes Forecast, 2015-2021 ……. 7-24
Exhibit 7-5: Refractive Laser Surgery, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 7-31
Exhibit 7-6: Strabismus Correction, Procedure Volumes Forecast, 2015-2021.. 7-35
Exhibit 7-7: Vitrectomy, Procedure Volumes Forecast, 2015-2021 ……………….. 7-38

8. ORTHOPEDIC/SPINE SURGICAL PROCEDURES……………………………… 8-1
8.1 Bone Fracture Repair ……………………………………………………………… 8-2
8.1.1 Fixation Device Materials ………………………………………….. 8-4
8.1.2 Bone Grafting ………………………………………………………….. 8-6
8.1.3 Biotechnology in Bone Fracture Repair……………………….. 8-7
8.1.4 Procedure Volumes………………………………………………….. 8-9
8.2 Total Joint Arthroplasty………………………………………………………….. 8-10
8.2.1 Total Knee Arthroplasty …………………………………………… 8-13
8.2.1.1 Procedure Volumes………………………………….. 8-14
8.2.2 Unicompartmental Knee Arthroplasty………………………… 8-15
8.2.2.1 Procedure Volumes………………………………….. 8-18
8.2.3 Hip Arthroplasty……………………………………………………… 8-18
8.2.3.1 Revision Hip Arthroplasty ………………………….. 8-22
8.2.3.2 Procedure Volumes………………………………….. 8-23
8.3 Spine Surgery………………………………………………………………………. 8-24
8.3.1 Total Disc Replacement ………………………………………….. 8-27
8.3.2 Nerve Root Decompression …………………………………….. 8-29
8.3.2.1 Discectomy……………………………………………… 8-29
8.3.2.1.1 Procedure Volumes ………………. 8-30
8.3.2.2 Laminectomy and Laminotomy…………………… 8-31
8.3.2.2.1 Procedure Volumes ………………. 8-33
8.3.3 Spinal Fusion…………………………………………………………. 8-34
8.3.3.1 Anterior Lumbar Interbody Fusion ………………. 8-36
8.3.3.2 Posterior Lumbar Interbody Fusion …………….. 8-37
8.3.3.3 Lateral Lumbar Interbody Fusion………………… 8-37
8.3.3.4 Instrumented Fusion…………………………………. 8-38
8.3.4 Vertebroplasty ……………………………………………………….. 8-38
8.3.4.1 Procedure Volumes………………………………….. 8-39
8.4 Arthroscopy …………………………………………………………………………. 8-40
8.4.1 Knee Arthroscopy…………………………………………………… 8-40
8.4.1.1 Procedure Volumes………………………………….. 8-43
8.4.1.2 Cartilage Repair and Transplantation………….. 8-43
8.4.1.3 Meniscectomy …………………………………………. 8-46
8.4.1.3.1 Procedure Volumes ………………. 8-47
8.4.1.4 Anterior Cruciate Ligament Reconstruction….. 8-47
8.4.1.4.1 Procedure Volumes ………………. 8-50
8.4.2 Shoulder Arthroscopy……………………………………………… 8-51
8.4.2.1 Primary Anterior Shoulder Dislocation…………. 8-53
8.4.2.2 Recurrent Anterior Shoulder Dislocation ……… 8-53
8.4.2.3 Acromioclavicular Joint Resection………………. 8-54
8.4.2.4 Rotator Cuff Repair ………………………………….. 8-55
8.4.2.5 Procedure Volumes………………………………….. 8-57
8.4.3 Wrist Arthroscopy …………………………………………………… 8-59
8.4.3.1 Carpal Tunnel Release……………………………… 8-60
8.4.3.2 Procedure Volumes………………………………….. 8-62
Exhibit 8-1: Open Fracture Reduction with Internal Fixation, Procedure Volumes Forecast, 2015-2021 ……………………………………………….. 8-11
Exhibit 8-2: Knee Arthroplasty, Procedure Volumes Forecast, 2015-2021……… 8-16
Exhibit 8-3: Unicompartmental Knee Arthroplasty, Procedure Volumes Forecast, 2015-2021 …………………………………………………………….. 8-19
Exhibit 8-4: Hip Arthroplasty, Procedure Volumes Forecast, 2015-2021………… 8-25
Exhibit 8-5: Discectomy, Procedure Volumes Forecast, 2015-2021………………. 8-32
Exhibit 8-6: Spinal Decompression, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 8-35
Exhibit 8-7: Spinal Fusion and Refusion, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 8-41
Exhibit 8-8: Arthroscopic Knee Surgery, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 8-44
Exhibit 8-9: Meniscectomy and Meniscal Repair, Procedure Volumes Forecast, 2015-2021 …………………………………………………………….. 8-48
Exhibit 8-10: Anterior Cruciate Ligament Reconstruction, Procedure Volumes Forecast, 2015-2021 ……………………………………………….. 8-52
Exhibit 8-11: Arthroscopic Shoulder Surgery, Procedure Volumes Forecast, 2015-2021 …………………………………………………………….. 8-58
Exhibit 8-12: Carpal Tunnel Release, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 8-63
9. UROLOGIC SURGICAL PROCEDURES……………………………………………. 9-1
9.1 Incontinence Management ………………………………………………………. 9-1
9.1.1 Procedure Volumes………………………………………………….. 9-6
9.2 Nephrectomy …………………………………………………………………………. 9-7
9.2.1 Procedure Volumes………………………………………………….. 9-9
9.3 Prostate Procedures……………………………………………………………… 9-10
9.3.1 Radical Prostatectomy…………………………………………….. 9-14
9.3.1.1 Procedure Volumes………………………………….. 9-16
9.3.2 Transurethral Resection of the Prostate…………………….. 9-17
9.3.2.1 Procedure Volumes………………………………….. 9-19
9.3.3 Directed Energy-Based Treatment for Benign Prostatic Hyperplasia …………………………………………………………… 9-20
9.3.3.1 Transurethral Microwave Thermotherapy…….. 9-22
9.3.3.2 Transurethral Needle Ablation……………………. 9-23
9.3.3.3 Laser Therapies for Benign Prostatic Hyperplasia …………………………………………….. 9-24
9.3.3.3.1 Diode Laser Vaporization of the Prostate ………………………………. 9-25
9.3.3.3.2 Holmium Laser Enucleation of the Prostate………………………….. 9-25
9.3.3.3.3 Photoselective Vaporization of the Prostate………………………….. 9-26
9.3.3.3.4 Thulium Laser Vapoenucleation of the Prostate………………………. 9-27
9.3.3.4 New Technology………………………………………. 9-27
9.3.3.5 Procedure Volumes………………………………….. 9-28
9.4 Urinary Stone Removal …………………………………………………………. 9-29
9.4.1 Extracorporeal Shock Wave Lithotripsy……………………… 9-31
9.4.2 Endoscopic Stone Removal …………………………………….. 9-32
9.4.3 Percutaneous Nephrolithotomy ………………………………… 9-33
9.4.4 Intracorporeal Lithotripsy …………………………………………. 9-34
9.4.4.1 Electrohydraulic Lithotripsy………………………… 9-34
9.4.4.2 Laser Lithotripsy ………………………………………. 9-35
9.4.4.3 Pneumatic Lithotripsy ……………………………….. 9-36
9.4.4.4 Ultrasonic Lithotripsy ………………………………… 9-37
9.4.5 Open Surgery ………………………………………………………… 9-37
9.4.6 Procedure Volumes………………………………………………… 9-38

Exhibit 9-1: Suspension and Sling Procedures for Stress Urinary Incontinence, Procedure Volumes Forecast, 2015-2021………………………………….. 9-8
Exhibit 9-2: Nephrectomy, Procedure Volumes Forecast, 2015-2021……………. 9-11
Exhibit 9-3: Radical Prostatectomy, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 9-18
Exhibit 9-4: Transurethral Resection of Prostate, Procedure Volumes Forecast, 2015-2021 …………………………………………………………….. 9-21
Exhibit 9-5: Directed Energy-Based Treatment for Benign Prostatic Hyperplasia, Procedure Volumes Forecast, 2015-2021 …………….. 9-30
Exhibit 9-6: Urinary Stone Removal, Procedure Volumes Forecast, 2015-2021 …………………………………………………………………………… 9-40
10. MISCELLANEOUS SURGICAL PROCEDURES ……………………………….. 10-1
10.1 Breast Procedures………………………………………………………………… 10-1
10.1.1 Breast Biopsy ………………………………………………………… 10-2
10.1.1.1 Surgical Biopsy………………………………………… 10-4
10.1.1.2 Percutaneous Biopsy ……………………………….. 10-5
10.1.1.3 Vacuum-Assisted Biopsy…………………………… 10-6
10.1.1.4 Procedure Volumes………………………………….. 10-7
10.1.2 Breast Conservation Surgery/Lumpectomy ………………… 10-7
10.1.2.1 Accelerated Partial Breast Irradiation ………… 10-10
10.1.2.2 Procedure Volumes………………………………… 10-11
10.1.3 Mastectomy …………………………………………………………. 10-12
10.1.3.1 Breast reconstruction ……………………………… 10-14
10.1.3.2 Prophylactic Mastectomy…………………………. 10-15
10.1.3.3 Simple Mastectomy ………………………………… 10-16
10.1.3.4 Radical and Modified Radical Mastectomy…. 10-16
10.1.3.5 Procedure Volumes………………………………… 10-16
10.2 Ear, Nose, and Throat Procedures ………………………………………… 10-17
10.2.1 Sinus Procedures …………………………………………………. 10-17
10.2.1.1 Procedure Volumes………………………………… 10-21
10.2.2 Tonsillectomy and Adenoidectomy………………………….. 10-21
10.2.2.1 Procedure Volumes………………………………… 10-27
10.2.3 Tracheotomy ……………………………………………………….. 10-28
10.2.3.1 Procedure Volumes………………………………… 10-31
10.3 Splenectomy………………………………………………………………………. 10-31
10.3.1 Procedure Volumes………………………………………………. 10-34

Exhibit 10-1: Breast Biopsy, Procedure Volumes Forecast, 2015-2021…………… 10-8
Exhibit 10-2: Lumpectomy, Procedure Volumes Forecast, 2015-2021…………… 10-13
Exhibit 10-3: Mastectomy, Procedure Volumes Forecast, 2015-2021……………. 10-18
Exhibit 10-4: Sinus Surgery, Procedure Volumes Forecast, 2015-2021…………. 10-22
Exhibit 10-5: Tonsillectomy and Adenoidectomy, Procedure Volumes Forecast, 2015-2021 …………………………………………………………… 10-29
Exhibit 10-6: Tracheotomy, Procedure Volumes Forecast, 2015-2021 ………….. 10-32
Exhibit 10-7: Splenectomy, Procedure Volumes Forecast, 2015-2021 ………….. 10-36

APPENDIX: BIBLIOGRAPHY