Table of Contents

1. CARDIOVASCULAR/THORACIC SURGICAL PROCEDURES …………….. 1-1
1.1 Circulatory Vascular Disorders …………………………………………………. 1-1
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 ……………………………………….. 1-5
1.1.5 Peripheral Vascular Disease ……………………………………… 1-7
1.1.5.1 Aortic Aneurysm………………………………………… 1-7
1.1.5.2 Lower Extremity Arterial Occlusion……………….. 1-8
1.1.5.3 Deep Vein Thrombosis and
Pulmonary Embolism ……………………………….. 1-10
1.2 Myocardial Disorders…………………………………………………………….. 1-12
1.2.1 Congenital Heart Defects ………………………………………… 1-12
1.2.2 Heart Valve Disorders …………………………………………….. 1-14
1.2.3 Heart Failure………………………………………………………….. 1-17
1.3 Cardiac Rhythm Disorders …………………………………………………….. 1-21
1.3.1 Bradycardia …………………………………………………………… 1-21
1.3.2 Supraventricular Tachycardia…………………………………… 1-22
1.3.2.1 Atrial Fibrillation……………………………………….. 1-22
1.3.3 Ventricular Tachycardia…………………………………………… 1-24
1.3.3.1 Ventricular Fibrillation……………………………….. 1-25
1.4 Therapeutic Management of Circulatory Disorders ……………………. 1-26
1.4.1 Coronary Artery Disease Treatment………………………….. 1-26
1.4.1.1 Coronary Artery Bypass Graft Surgery………… 1-27
1.4.1.1.1 Less Invasive Coronary Artery
Bypass Graft Surgery…………….. 1-27
1.4.1.1.2 Patient Indications…………………. 1-29
1.4.1.1.3 Procedure Volumes ………………. 1-31
1.4.1.2 Percutaneous Coronary Interventions …………. 1-32
1.4.1.2.1 Percutaneous Transluminal
Coronary Angioplasty
and Stenting…………………………. 1-32
1.4.1.2.1.1 Procedure
Volumes …………… 1-36
1.4.1.2.2 Mechanical Atherectomy………… 1-37
1.4.1.2.2.1 Procedure
Volumes …………… 1-40
1.4.1.2.3 Laser Coronary Atherectomy ….. 1-41
1.4.1.2.3.1 Procedure
Volumes …………… 1-43
1.4.1.2.4 Mechanical Coronary
Thrombectomy……………………… 1-44
1.4.1.2.4.1 Procedure
Volumes …………… 1-44
1.4.1.3 Transmyocardial Laser Revascularization……. 1-46
1.4.1.3.1 Procedure Volumes ………………. 1-48
1.4.2 Peripheral Vascular Disease Treatment…………………….. 1-49
1.4.2.1 Aortic Aneurysm Treatment Regimens………… 1-49
1.4.2.1.1 Surgical Repair of
Aortic Aneurysms………………….. 1-49
1.4.2.1.2 Abdominal Aortic Aneurysm
Repair/Endovascular
Stent Grafting……………………….. 1-51
1.4.2.1.2.1 Limitations of
Endovascular
Abdominal Aortic
Aneurysm Repair.. 1-52
1.4.2.1.3 Endovascular Thoracic Aortic
Aneurysm Repair ………………….. 1-52
1.4.2.1.4 Procedure Volumes ………………. 1-53
1.4.2.2 Treatment of Lower Extremity
Arterial Occlusions …………………………………… 1-54
1.4.2.2.1 Bypass Graft Surgery for Lower
Extremity Revascularization……. 1-54
1.4.2.2.1.1 Aortoiliofemoral
Bypass Graft
Surgery…………….. 1-56
1.4.2.2.1.2 Tibioperoneal
Reconstruction ….. 1-56
1.4.2.2.1.3 Femoropopliteal
Bypass Surgery …. 1-57
1.4.2.2.1.4 Procedure
Volumes …………… 1-57
1.4.2.2.2 Percutaneous Transluminal
Angioplasty ………………………….. 1-58
1.4.2.2.2.1 Procedure
Volumes …………… 1-60
1.4.2.2.3 Lower Extremity Stenting ……….. 1-60
1.4.2.2.3.1 Iliac Artery
Stenting ……………. 1-62
1.4.2.2.3.2 Femoropopliteal
Artery Stenting…… 1-63
1.4.2.2.3.3 Infrapopliteal/
Below-the-Knee
Stenting ……………. 1-63
1.4.2.2.3.4 Procedure
Volumes …………… 1-64
1.4.2.2.4 Peripheral Mechanical
Atherectomy…………………………. 1-64
1.4.2.2.4.1 Procedure
Volumes …………… 1-66
1.4.2.2.5 Peripheral Excimer
Laser Atherectomy………………… 1-68
1.4.2.2.5.1 Procedure
Volumes …………… 1-68
1.4.2.2.6 Peripheral Mechanical
Thrombectomy……………………… 1-69
1.4.2.2.6.1 Procedure
Volumes …………… 1-71
1.5 Therapeutic Management of Myocardial Disorders ……………………. 1-71
1.5.1 Congenital Heart Defect Repair………………………………… 1-71
1.5.1.1 Procedure Volumes………………………………….. 1-73
1.5.2 Treatment of Heart Valve Disorders ………………………….. 1-76
1.5.2.1 Percutaneous Balloon Valvuloplasty …………… 1-76
1.5.2.1.1 Procedure Volumes ………………. 1-77
1.5.2.2 Heart Valve Repair and Replacement…………. 1-78
1.5.2.2.1 Procedure Volumes ………………. 1-80
1.5.3 Ventricular Assist Devices for Late-Stage Heart Failure.. 1-81
1.5.3.1 Procedure Volumes………………………………….. 1-86
1.6 Implantable Devices for Cardiac Rhythm Management………………. 1-86
1.6.1 Cardiac Pacing Systems …………………………………………. 1-88
1.6.1.1 Magnetic Resonance
Imaging-Safe Pacemakers ………………………… 1-89
1.6.1.2 Procedure Volumes………………………………….. 1-89
1.6.2 Implantable Cardioverter Defibrillators ………………………. 1-90
1.6.2.1 Procedure Volumes………………………………….. 1-93
1.6.3 Cardiac Resynchronization Therapy Systems…………….. 1-93
1.6.3.1 Procedure Volumes………………………………….. 1-96
1.7 Thoracic Surgery ………………………………………………………………….. 1-97
1.7.1 Thoracotomy …………………………………………………………. 1-99
1.7.2 Thoracoscopy………………………………………………………. 1-100
Exhibit 1-1: On-Pump and Off-Pump Coronary Artery Bypass Graft Surgery,
Procedure Volumes Forecast, 2011-2018………………………………… 1-33
Exhibit 1-2: Percutaneous Transluminal Coronary Angioplasty/Stenting,
Procedure Volumes Forecast, 2011-2018………………………………… 1-38
Exhibit 1-3: Mechanical Coronary Atherectomy,
Procedure Volumes Forecast, 2011-2018………………………………… 1-42
Exhibit 1-4: Laser Coronary Atherectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 1-45
Exhibit 1-5: Mechanical Coronary Thrombectomy,
Procedure Volumes Forecast, 2011-2018………………………………… 1-47
Exhibit 1-6: Transmyocardial Laser Revascularization,
Procedure Volumes Forecast, 2011-2018………………………………… 1-50
Exhibit 1-7: Aortic Aneurysm Repair, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 1-55
Exhibit 1-8: Lower Extremity Surgical Bypass Grafting,
Procedure Volumes Forecast, 2011-2018………………………………… 1-59
Exhibit 1-9: Percutaneous Transluminal Angioplasty,
Procedure Volumes Forecast, 2011-2018………………………………… 1-61
Exhibit 1-10: Lower Extremity Stenting, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 1-65
Exhibit 1-11: Peripheral Mechanical Atherectomy,
Procedure Volumes Forecast, 2011-2018………………………………… 1-67
Exhibit 1-12: Peripheral Excimer Laser Atherectomy,
Procedure Volumes Forecast, 2011-2018………………………………… 1-70
Exhibit 1-13: Peripheral Mechanical Thrombectomy,
Procedure Volumes Forecast, 2011-2018………………………………… 1-72
Exhibit 1-14: Clinical Presentation and Share of Common
Congenital Heart Defects ………………………………………………………. 1-74
Exhibit 1-15: Congenital Heart Defect Repair,
Procedure Volumes Forecast, 2011-2018………………………………… 1-75
Exhibit 1-16: Percutaneous Balloon Valvuloplasty,
Procedure Volumes Forecast, 2011-2018………………………………… 1-79
Exhibit 1-17: Heart Valve Repair and Replacement,
Procedure Volumes Forecast, 2011-2018………………………………… 1-82
Exhibit 1-18: Ventricular Assist Device Placement,
Procedure Volumes Forecast, 2011-2018………………………………… 1-87
Exhibit 1-19: Pacemaker Implantation, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 1-91
Exhibit 1-20: Implantable Cardioverter Defibrillator Placement,
Procedure Volumes Forecast, 2011-2018………………………………… 1-94
Exhibit 1-21: Cardiac Resynchronization Therapy Device Placement,
Procedure Volumes Forecast, 2011-2018………………………………… 1-98
Exhibit 1-22: Thoracotomy, Procedure Volumes Forecast, 2011-2018 ………….. 1-101
Exhibit 1-23: Thoracoscopy, Procedure Volumes Forecast, 2011-2018…………. 1-103
2. COSMETIC SURGICAL PROCEDURES ……………………………………………. 2-1
2.1 Abdominoplasty……………………………………………………………………… 2-2
2.2 Augmentation and Reduction Mammoplasty………………………………. 2-3
2.3 Blepharoplasty……………………………………………………………………….. 2-7
2.4 Hair Transplantation ……………………………………………………………… 2-11
2.5 Liposuction ………………………………………………………………………….. 2-14
2.6 Rhytidectomy……………………………………………………………………….. 2-16
2.7 Trends in Cosmetic Surgery …………………………………………………… 2-18
Exhibit 2-1: Abdominoplasty, Procedure Volumes Forecast, 2011-2018………….. 2-4
Exhibit 2-2: Breast Augmentation and Reduction Mammoplasty,
Procedure Volumes Forecast, 2011-2018………………………………….. 2-8
Exhibit 2-3: Blepharoplasty, Procedure Volumes Forecast, 2011-2018 …………. 2-10
Exhibit 2-4: Hair Transplantation, Procedure Volumes Forecast, 2011-2018….. 2-13
Exhibit 2-5: Liposuction, Procedure Volumes Forecast, 2011-2018………………. 2-17
Exhibit 2-6: Rhytidectomy, Procedure Volumes Forecast, 2011-2018 …………… 2-19
3. GENERAL SURGICAL PROCEDURES……………………………………………… 3-1
3.1 Abdominal Adhesiolysis…………………………………………………………… 3-1
3.2 Appendectomy ………………………………………………………………………. 3-4
3.3 Bariatric Surgery…………………………………………………………………….. 3-6
3.4 Cholecystectomy ………………………………………………………………….. 3-11
3.5 Esophagogastric Fundoplasty ………………………………………………… 3-14
3.6 Inguinal Herniorrhaphy ………………………………………………………….. 3-17
3.7 Large Intestine Procedures ……………………………………………………. 3-20
3.7.1 Colectomy and Sigmoidectomy………………………………… 3-20
3.7.2 Hemorrhoid Surgery ……………………………………………….. 3-23
3.8 Liver Biopsy…………………………………………………………………………. 3-26
Exhibit 3-1: Abdominal Adhesiolysis, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………….. 3-5
Exhibit 3-2: Appendectomy, Procedure Volumes Forecast, 2011-2018 …………… 3-7
Exhibit 3-3: Bariatric/Gastric Bypass, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 3-12
Exhibit 3-4: Cholecystectomy, Procedure Volumes Forecast, 2011-2018………. 3-15
Exhibit 3-5: Esophagogastric Fundoplasty, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 3-18
Exhibit 3-6: Inguinal Herniorrhaphy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 3-21
Exhibit 3-7: Colectomy and Sigmoidectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 3-24
Exhibit 3-8: Hemorrhoidectomy, Procedure Volumes Forecast, 2011-2018……. 3-27
Exhibit 3-9: Liver Biopsy, Procedure Volumes Forecast, 2011-2018……………… 3-30
4. MAJOR ORGAN/STEM CELL/TISSUE TRANSPLANTATION ……………… 4-1
4.1 Organ Donor Shortage ……………………………………………………………. 4-1
4.2 Organ Transplants and Immunosuppressive Strategies……………….. 4-7
4.3 Major Organ Transplantation……………………………………………………. 4-9
4.3.1 Heart Transplants…………………………………………………….. 4-9
4.3.2 Heart-Lung Transplants…………………………………………….. 4-9
4.3.3 Intestinal Transplants ……………………………………………… 4-10
4.3.4 Kidney Transplants…………………………………………………. 4-11
4.3.5 Kidney-Pancreas Transplants ………………………………….. 4-12
4.3.6 Liver Transplants……………………………………………………. 4-12
4.3.7 Lung Transplants……………………………………………………. 4-13
4.3.8 Pancreas Transplants …………………………………………….. 4-14
4.3.9 Procedure Volumes………………………………………………… 4-15
4.4 Bone Marrow and Stem Cell Transplantation ……………………………. 4-19
4.4.1 Non-Myeloablative Transplants………………………………… 4-21
4.4.2 Syngeneic Transplants……………………………………………. 4-22
4.4.3 Allogeneic Transplants ……………………………………………. 4-22
4.4.4 Autologous Transplants…………………………………………… 4-22
4.4.5 Other Sources of Stem Cells……………………………………. 4-22
4.4.6 Procedure Volumes………………………………………………… 4-23
4.5 Corneal Transplantation ………………………………………………………… 4-26
4.5.1 Procedure Volumes………………………………………………… 4-30
Exhibit 4-1: 2013, Patients Awaiting Organ Transplants ……………………………….. 4-3
Exhibit 4-2: 2012, Major Organ Transplants………………………………………………… 4-6
Exhibit 4-3: 2012, Patient Survival Rates at 1 and 5 Years,
by Transplanted Organ………………………………………………………….. 4-16
Exhibit 4-4: Cadaveric and Living Donor Organ Transplants,
Historical Procedure Volumes, 2002-2012 ……………………………….. 4-17
Exhibit 4-5: Major Organ Transplantation, Procedure Volumes Forecast,
by Type, 2011-2018………………………………………………………………. 4-20
Exhibit 4-6: 2012, Unrelated Bone Marrow Stem Cell Transplants,
by Primary Diagnosis…………………………………………………………….. 4-24
Exhibit 4-7: Unrelated Bone Marrow Stem Cell Transplants,
Historical Procedure Volumes, by Primary Diagnosis
for Selected Years, 2002-2012……………………………………………….. 4-25
Exhibit 4-8: Unrelated Stem Cell Transplants, Historical Procedure Volumes,
by Cell Source, 2002-2012…………………………………………………….. 4-27
Exhibit 4-9: Unrelated Stem Cell Transplantation,
Procedure Volumes Forecast, by Cell Source, 2011-2018………….. 4-28
Exhibit 4-10: Corneal Transplantation, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 4-31
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………………….. 5-10
5.7 Neurosurgical Procedures ……………………………………………………… 5-12
5.7.1 Cerebrospinal Fluid Shunting and Drainage……………….. 5-12
5.7.1.1 Procedure Volumes………………………………….. 5-14
5.7.2 Carotid Endarterectomy…………………………………………… 5-14
5.7.2.1 Procedure Volumes………………………………….. 5-16
5.7.3 Cerebral Aneurysm and Arteriovenous
Malformation Surgical Clipping…………………………………. 5-16
5.7.3.1 Procedure Volumes………………………………….. 5-19
5.7.4 Cerebral Aneurysm and Arteriovenous
Malformation Embolization ………………………………………. 5-19
5.7.4.1 Procedure Volumes………………………………….. 5-21
5.7.5 Carotid Artery Stenting ……………………………………………. 5-23
5.7.5.1 Carotid Revascularization Endarterectomy
versus Stenting Trial Results……………………… 5-24
5.7.5.2 Procedure Volumes………………………………….. 5-25
5.7.6 Intracranial Stenting ……………………………………………….. 5-26
5.7.6.1 Procedure Volumes………………………………….. 5-28
Exhibit 5-1: Cerebrospinal Fluid Shunting, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 5-15
Exhibit 5-2: Carotid Endarterectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 5-17
Exhibit 5-3: Cerebral Aneurysm and Arteriovenous Malformation
Surgical Clipping, Procedure Volumes Forecast, 2011-2018 ………. 5-20
Exhibit 5-4: Cerebral Aneurysm and Arteriovenous Malformation
Embolization, Procedure Volumes Forecast, 2011-2018…………….. 5-22
Exhibit 5-5: Distally Protected Carotid Artery Stenting,
Procedure Volumes Forecast, 2011-2018………………………………… 5-27
Exhibit 5-6: Intracranial Stenting, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 5-29
6. OBSTETRIC/GYNECOLOGIC SURGICAL PROCEDURES………………….. 6-1
6.1 Dysfunctional Uterine Bleeding ………………………………………………… 6-1
6.2 Gynecologic Procedures …………………………………………………………. 6-2
6.2.1 Dilation and Curettage………………………………………………. 6-3
6.2.1.1 Procedure Volumes……………………………………. 6-4
6.2.2 Hysterectomy ………………………………………………………….. 6-4
6.2.2.1 Minimally Invasive Techniques…………………….. 6-7
6.2.2.2 Procedure Volumes……………………………………. 6-8
6.2.3 Hysteroscopy…………………………………………………………… 6-8
6.2.3.1 Endometrial Ablation ………………………………… 6-11
6.2.3.2 Procedure Volumes………………………………….. 6-12
6.2.4 Myomectomy…………………………………………………………. 6-13
6.2.4.1 Procedure Volumes………………………………….. 6-16
6.2.5 Diagnostic Procedures for Infertility…………………………… 6-16
6.2.5.1 Hysterosonography, Hysterosalpingography,
and Laparoscopy……………………………………… 6-18
6.2.5.2 Procedure Volumes………………………………….. 6-20
6.3 Female Sterilization………………………………………………………………. 6-22
6.3.1 Tubal Ligation………………………………………………………… 6-22
6.3.1.1 Procedure Volumes………………………………….. 6-23
6.4 Obstetric Procedures…………………………………………………………….. 6-23
6.4.1 Live Birth ………………………………………………………………. 6-23
6.4.1.1 Procedure Volumes………………………………….. 6-25
6.4.2 Cesarean Section…………………………………………………… 6-25
6.4.2.1 Procedure Volumes………………………………….. 6-29
Exhibit 6-1: Dilation and Curettage, Procedure Volumes Forecast, 2011-2018 … 6-5
Exhibit 6-2: Hysterectomy, Procedure Volumes Forecast, 2011-2018 …………….. 6-9
Exhibit 6-3: Hysteroscopy, Procedure Volumes Forecast, 2011-2018 …………… 6-14
Exhibit 6-4: Myomectomy, Procedure Volumes Forecast, 2011-2018……………. 6-17
Exhibit 6-5: Diagnostic Examinations for Infertility,
Procedure Volumes Forecast, 2011-2018………………………………… 6-21
Exhibit 6-6: Tubal Ligation, Procedure Volumes Forecast, 2011-2018…………… 6-24
Exhibit 6-7: Live Births, Historical Procedure Volumes, 1991-2011……………….. 6-26
Exhibit 6-8: Live Births, Procedure Volumes Forecast, 2011-2018 ……………….. 6-27
Exhibit 6-9: Cesarean Section, Procedure Volumes Forecast, 2011-2018……… 6-30
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 …………………………….. 7-2
7.1.3 Transpupillary Thermotherapy……………………………………. 7-3
7.1.4 Retinal Photocoagulation…………………………………………… 7-4
7.1.5 Procedure Volumes………………………………………………….. 7-4
7.2 Cataract Surgery ……………………………………………………………………. 7-6
7.2.1 Capsulotomy …………………………………………………………. 7-10
7.2.2 Procedure Volumes………………………………………………… 7-10
7.3 Diabetic Retinopathy …………………………………………………………….. 7-10
7.3.1 Procedure Volumes………………………………………………… 7-14
7.4 Glaucoma Surgery………………………………………………………………… 7-14
7.4.1 Procedure Volumes………………………………………………… 7-18
7.5 Refractive Surgery………………………………………………………………… 7-18
7.5.1 Laser-Based Vision Correction…………………………………. 7-20
7.5.1.1 Photorefractive Keratectomy ……………………… 7-20
7.5.1.2 Laser In Situ Keratomileusis………………………. 7-21
7.5.1.2.1 Laser Epithelial Keratomileusis.. 7-22
7.5.1.2.2 Custom Laser
In Situ Keratomileusis ……………. 7-22
7.5.1.2.3 Photoablative Inlay Laser
In Situ Keratomileusis ……………. 7-23
7.5.1.3 Procedure Volumes………………………………….. 7-23
7.6 Strabismus Correction…………………………………………………………… 7-24
7.6.1 Procedure Volumes………………………………………………… 7-26
7.7 Vitrectomy …………………………………………………………………………… 7-28
7.7.1 Procedure Volumes………………………………………………… 7-29
Exhibit 7-1: Laser Therapy for Age-Related Macular Degeneration,
Procedure Volumes Forecast, 2011-2018………………………………….. 7-5
Exhibit 7-2: Cataract Surgery, Procedure Volumes Forecast, 2011-2018 ………. 7-11
Exhibit 7-3: Diabetic Retinopathy Laser Surgery,
Procedure Volumes Forecast, 2011-2018 …………………………………… 15
Exhibit 7-4: Glaucoma Surgery, Procedure Volumes Forecast, 2011-2018 ……. 7-19
Exhibit 7-5: Refractive Laser Surgery, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 7-25
Exhibit 7-6: Strabismus Correction, Procedure Volumes Forecast, 2011-2018.. 7-27
Exhibit 7-7: Vitrectomy, Procedure Volumes Forecast, 2011-2018 ……………….. 7-30
8. ORTHOPEDIC/SPINE SURGICAL PROCEDURES……………………………… 8-1
8.1 Bone Fracture Repair ……………………………………………………………… 8-2
8.1.1 Bone Grafting ………………………………………………………….. 8-4
8.1.2 Biotechnology in Bone Fracture Repair……………………….. 8-6
8.1.3 Procedure Volumes………………………………………………….. 8-7
8.2 Total Joint Arthroplasty……………………………………………………………. 8-9
8.2.1 Total Knee Arthroplasty…………………………………………… 8-10
8.2.1.1 Procedure Volumes………………………………….. 8-11
8.2.2 Unicompartmental Knee Arthroplasty………………………… 8-11
8.2.2.1 Procedure Volumes………………………………….. 8-13
8.2.3 Hip Arthroplasty……………………………………………………… 8-15
8.2.3.1 Revision Hip Arthroplasty ………………………….. 8-18
8.2.3.2 Procedure Volumes………………………………….. 8-18
8.3 Spine Surgery………………………………………………………………………. 8-20
8.3.1 Total Disc Replacement ………………………………………….. 8-21
8.3.2 Nerve Root Decompression …………………………………….. 8-22
8.3.2.1 Discectomy……………………………………………… 8-22
8.3.2.1.1 Procedure Volumes ………………. 8-23
8.3.2.2 Laminectomy and Laminotomy…………………… 8-23
8.3.2.2.1 Procedure Volumes ………………. 8-26
8.3.3 Spinal Fusion…………………………………………………………. 8-26
8.3.3.1 Anterior Lumbar Interbody Fusion………………. 8-28
8.3.3.2 Posterior Lumbar Interbody Fusion …………….. 8-29
8.3.3.3 Lateral Lumbar Interbody Fusion………………… 8-29
8.3.3.4 Instrumented Fusion…………………………………. 8-29
8.3.4 Vertebroplasty ……………………………………………………….. 8-30
8.3.4.1 Procedure Volumes………………………………….. 8-31
8.4 Arthroscopy …………………………………………………………………………. 8-31
8.4.1 Knee Arthroscopy…………………………………………………… 8-31
8.4.1.1 Procedure Volumes………………………………….. 8-33
8.4.1.2 Cartilage Repair and Transplantation………….. 8-34
8.4.1.3 Meniscectomy …………………………………………. 8-36
8.4.1.3.1 Procedure Volumes ………………. 8-37
8.4.1.4 Anterior Cruciate Ligament Reconstruction….. 8-37
8.4.1.4.1 Procedure Volumes ………………. 8-40
8.4.2 Shoulder Arthroscopy……………………………………………… 8-40
8.4.2.1 Primary Anterior Shoulder Dislocation…………. 8-42
8.4.2.2 Recurrent Anterior Shoulder Dislocation ……… 8-42
8.4.2.3 Acromioclavicular Joint Resection………………. 8-43
8.4.2.4 Rotator Cuff Repair ………………………………….. 8-44
8.4.2.5 Procedure Volumes………………………………….. 8-45
8.4.3 Wrist Arthroscopy …………………………………………………… 8-46
8.4.3.1 Carpal Tunnel Release……………………………… 8-48
8.4.3.2 Procedure Volumes………………………………….. 8-50
Exhibit 8-1: Open Fracture Reduction with Internal Fixation,
Procedure Volumes Forecast, 2011-2018………………………………….. 8-8
Exhibit 8-2: Knee Arthroplasty, Procedure Volumes Forecast, 2011-2018……… 8-12
Exhibit 8-3: Unicompartmental Knee Arthroplasty,
Procedure Volumes Forecast, 2011-2018………………………………… 8-14
Exhibit 8-4: Hip Arthroplasty, Procedure Volumes Forecast, 2011-2018………… 8-19
Exhibit 8-5: Discectomy, Procedure Volumes Forecast, 2011-2018………………. 8-24
Exhibit 8-6: Spinal Decompression, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 8-27
Exhibit 8-7: Spinal Fusion and Refusion, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 8-32
Exhibit 8-8: Arthroscopic Knee Surgery, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 8-35
Exhibit 8-9: Meniscectomy and Meniscal Repair,
Procedure Volumes Forecast, 2011-2018………………………………… 8-38
Exhibit 8-10: Anterior Cruciate Ligament Reconstruction,
Procedure Volumes Forecast, 2011-2018………………………………… 8-41
Exhibit 8-11: Arthroscopic Shoulder Surgery, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 8-47
Exhibit 8-12: Carpal Tunnel Release, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 8-51
9. UROLOGIC SURGICAL PROCEDURES……………………………………………. 9-1
9.1 Incontinence Management ………………………………………………………. 9-1
9.1.1 Procedure Volumes………………………………………………….. 9-4
9.2 Nephrectomy …………………………………………………………………………. 9-5
9.2.1 Procedure Volumes………………………………………………….. 9-7
9.3 Prostate Procedures……………………………………………………………….. 9-9
9.3.1 Radical Prostatectomy ……………………………………………. 9-11
9.3.1.1 Procedure Volumes………………………………….. 9-14
9.3.2 Transurethral Resection of the Prostate…………………….. 9-14
9.3.2.1 Procedure Volumes………………………………….. 9-16
9.3.3 Directed Energy-Based Treatment for
Benign Prostatic Hyperplasia …………………………………… 9-17
9.3.3.1 Transurethral Microwave Thermotherapy…….. 9-19
9.3.3.2 Transurethral Needle Ablation……………………. 9-20
9.3.3.3 Laser Therapies for Benign
Prostatic Hyperplasia ……………………………….. 9-21
9.3.3.3.1 Diode Laser Vaporization
of the Prostate ……………………… 9-22
9.3.3.3.2 Holmium Laser Enucleation
of the Prostate ……………………… 9-22
9.3.3.3.3 Photoselective Vaporization
of the Prostate ……………………… 9-23
9.3.3.3.4 Thulium Laser Vapoenucleation
of the Prostate ……………………… 9-24
9.3.3.4 Procedure Volumes………………………………….. 9-24
9.4 Urinary Stone Removal …………………………………………………………. 9-25
9.4.1 Extracorporeal Shock Wave Lithotripsy……………………… 9-25
9.4.2 Endoscopic Stone Removal …………………………………….. 9-27
9.4.3 Percutaneous Nephrolithotomy ………………………………… 9-28
9.4.4 Intracorporeal Lithotripsy…………………………………………. 9-29
9.4.4.1 Electrohydraulic Lithotripsy ……………………….. 9-29
9.4.4.2 Laser Lithotripsy………………………………………. 9-30
9.4.4.3 Pneumatic Lithotripsy ……………………………….. 9-31
9.4.4.4 Ultrasonic Lithotripsy………………………………… 9-32
9.4.5 Open Surgery………………………………………………………… 9-32
9.4.6 Procedure Volumes………………………………………………… 9-33
Exhibit 9-1: Suspension and Sling Procedures for Stress Urinary Incontinence,
Procedure Volumes Forecast, 2011-2018………………………………….. 9-6
Exhibit 9-2: Nephrectomy, Procedure Volumes Forecast, 2011-2018……………… 9-8
Exhibit 9-3: Radical Prostatectomy, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 9-15
Exhibit 9-4: Transurethral Resection of Prostate,
Procedure Volumes Forecast, 2011-2018………………………………… 9-18
Exhibit 9-5: Directed Energy-Based Treatment for Benign Prostatic
Hyperplasia, Procedure Volumes Forecast, 2011-2018 ……………… 9-26
Exhibit 9-6: Urinary Stone Removal, Procedure Volumes Forecast,
2011-2018 …………………………………………………………………………… 9-34
10. MISCELLANEOUS SURGICAL PROCEDURES ……………………………….. 10-1
10.1 Breast Procedures………………………………………………………………… 10-1
10.1.1 Breast Biopsy ………………………………………………………… 10-1
10.1.1.1 Surgical Biopsy………………………………………… 10-3
10.1.1.2 Percutaneous Biopsy ……………………………….. 10-4
10.1.1.3 Vacuum-Assisted Biopsy…………………………… 10-5
10.1.1.4 Procedure Volumes………………………………….. 10-6
10.1.2 Lumpectomy………………………………………………………….. 10-6
10.1.2.1 Procedure Volumes………………………………….. 10-9
10.1.3 Mastectomy…………………………………………………………… 10-9
10.1.3.1 Prophylactic Mastectomy ………………………… 10-12
10.1.3.2 Simple Mastectomy………………………………… 10-12
10.1.3.3 Radical and Modified Radical Mastectomy…. 10-13
10.1.3.4 Procedure Volumes………………………………… 10-13
10.2 Ear, Nose, and Throat Procedures………………………………………… 10-13
10.2.1 Sinus Procedures …………………………………………………. 10-15
10.2.1.1 Procedure Volumes………………………………… 10-17
10.2.2 Tonsillectomy and Adenoidectomy………………………….. 10-19
10.2.2.1 Procedure Volumes………………………………… 10-22
10.2.3 Tracheotomy ……………………………………………………….. 10-22
10.2.3.1 Procedure Volumes………………………………… 10-25
10.3 Splenectomy………………………………………………………………………. 10-25
10.3.1 Procedure Volumes………………………………………………. 10-27
Exhibit 10-1: Breast Biopsy, Procedure Volumes Forecast, 2011-2018…………… 10-7
Exhibit 10-2: Lumpectomy, Procedure Volumes Forecast, 2011-2018…………… 10-10
Exhibit 10-3: Mastectomy, Procedure Volumes Forecast, 2011-2018……………. 10-14
Exhibit 10-4: Sinus Surgery, Procedure Volumes Forecast, 2011-2018…………. 10-18
Exhibit 10-5: Tonsillectomy and Adenoidectomy,
Procedure Volumes Forecast, 2011-2018………………………………. 10-23
Exhibit 10-6: Tracheotomy, Procedure Volumes Forecast, 2011-2018 ………….. 10-26
Exhibit 10-7: Splenectomy, Procedure Volumes Forecast, 2011-2018 ………….. 10-28