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ESP Database Plus TF 2004-2009 Gen Shell

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ESP Database Plus TF 2004-2009 Gen Shell Powered By Docstoc
					                                                                                                                               % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                         Higher Incidence/Demand




                                                                                                                                                                                                                                                          Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                   Lower Incidence/Demand
                                                                                                                                                                  Improved Technique/T




                                                                                                                                                                                                                                       Higher Awareness
                                                                                                                                                                                                                      Growth/Greying
                                                                              France 2004     France 2005   France 2006




                                                                                                                                                                                                                                                               of Technique
     SURGICAL                                                      CODING




                                                                                                                                                                                                                        Population

                                                                                                                                                                                                                        Population
                                                                                                                                                                       echnology
ID                    CATEGORY                PROCEDURE                        Procedure       Procedure     Procedure                           (See Methods
     SPECIALTY                                                   (ICD-9-CM)                                                                         Tab for
                                                                                Volumes         Volumes       Volumes     % Change '06 vs. '05
                                                                                                                                                 Description of
                                                                                                                                                   Process)




                 Operations on thyroid    Unilateral thyroid
1    GENERAL                                                        06.2
                 and parathyroid glands   lobectomy




                 Operations on thyroid    Complete
2    GENERAL                                                        06.4
                 and parathyroid glands   thyroidectomy




                 Operations on thyroid
3    GENERAL                              Parathyroidectomy         06.8
                 and parathyroid glands




                 Operations on other
4    GENERAL                              Total adrenalectomy       07.3
                 endocrine glands




                 Operations on other
5    GENERAL                              Hypophysectomy            07.6
                 endocrine glands




                 Operations on lymphatic Incision of lymphatic
6    GENERAL                                                        40.0
                 system                  structures




                 Operations on lymphatic Biopsy of lymphatic
7    GENERAL                                                       40.11      Not available
                 system                  structure
                                                                                                                                  % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                            Higher Incidence/Demand




                                                                                                                                                                                                                                                             Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                      Lower Incidence/Demand
                                                                                                                                                                     Improved Technique/T




                                                                                                                                                                                                                                          Higher Awareness
                                                                                                                                                                                                                         Growth/Greying
                                                                                   France 2004   France 2005   France 2006




                                                                                                                                                                                                                                                                  of Technique
     SURGICAL                                                        CODING




                                                                                                                                                                                                                           Population

                                                                                                                                                                                                                           Population
                                                                                                                                                                          echnology
ID                     CATEGORY                 PROCEDURE                           Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                                                     (ICD-9-CM)                                                                          Tab for
                                                                                     Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                                                    Description of
                                                                                                                                                      Process)




                 Operations on lymphatic                            40.2 40.3
8    GENERAL                             Lymphadenectomy
                 system                                             40.4 40.5




                                            Bone marrow or
                 Operations on bone
9    GENERAL                                hematopoietic stem         41.0
                 marrow and spleen
                                            cell transplant




                 Operations on bone
10   GENERAL                                Splenectomy             41.43 41.5
                 marrow and spleen




                 Operations on
11   GENERAL                                Esophagectomy              42.4
                 esophagus




                 Operations on
12   GENERAL                                Esophagomyotomy            42.7
                 esophagus




                 Incision and excision of
13   GENERAL                                Gastrotomy                 43.0
                 stomach




                 Incision and excision of
14   GENERAL                                Pyloromyotomy              43.3
                 stomach




                                            Open extirpation of
15   GENERAL     Bariatric surgery
                                            lesion of stomach




                 Incision and excision of                         43.5 43.6 43.7
16   GENERAL                                Gastrectomy
                 stomach                                             43.8 43.9
                                                                                                                                         % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                                   Higher Incidence/Demand




                                                                                                                                                                                                                                                                    Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                             Lower Incidence/Demand
                                                                                                                                                                            Improved Technique/T




                                                                                                                                                                                                                                                 Higher Awareness
                                                                                                                                                                                                                                Growth/Greying
                                                                                    France 2004     France 2005     France 2006




                                                                                                                                                                                                                                                                         of Technique
     SURGICAL                                                         CODING




                                                                                                                                                                                                                                  Population

                                                                                                                                                                                                                                  Population
                                                                                                                                                                                 echnology
ID                     CATEGORY                 PROCEDURE                            Procedure       Procedure       Procedure                             (See Methods
     SPECIALTY                                                      (ICD-9-CM)                                                                                Tab for
                                                                                      Volumes         Volumes         Volumes       % Change '06 vs. '05
                                                                                                                                                           Description of
                                                                                                                                                             Process)




                 Incision and excision of
17   GENERAL                                Vagotomy                    44.0
                 stomach




                                            Gastroenterostomy
                 Incision and excision of
18   GENERAL                                without gastrectomy         44.3
                 stomach
                                            (gastric bypass)




                                            Gastric Bypass,
19   GENERAL     Bariatric surgery
                                            laparoscopic




20   GENERAL     Bariatric surgery          Gastric Bypass, open




                 Operations on
21   GENERAL                                Fundoplication          Part of 44.66
                 esophagus




22   GENERAL     Bariatric surgery          Gastroplasty            44.68 44.69




                                            (Laparoscopic)
                                            adjustment of size of
23   GENERAL     Bariatric Surgery                                     44.98        Not available   Not available   Not available
                                            adjustable gastric
                                            restrictive device



                 Incision, excision, and
24   GENERAL                              Enterotomy                    45.0
                 anastomosis of intestine




                 Incision, excision, and  Excision of small
25   GENERAL                                                         45.3, 45.63
                 anastomosis of intestine intestine
                                                                                                                                     % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                               Higher Incidence/Demand




                                                                                                                                                                                                                                                                Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                         Lower Incidence/Demand
                                                                                                                                                                        Improved Technique/T




                                                                                                                                                                                                                                             Higher Awareness
                                                                                                                                                                                                                            Growth/Greying
                                                                                      France 2004   France 2005   France 2006




                                                                                                                                                                                                                                                                     of Technique
     SURGICAL                                                          CODING




                                                                                                                                                                                                                              Population

                                                                                                                                                                                                                              Population
                                                                                                                                                                             echnology
ID                     CATEGORY                PROCEDURE                               Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                                                       (ICD-9-CM)                                                                           Tab for
                                                                                        Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                                                       Description of
                                                                                                                                                         Process)




                 Incision, excision, and
26   GENERAL                              Small bowel resection   45.61 45.62 45.51
                 anastomosis of intestine




                 Incision, excision, and  Excision of large
27   GENERAL                                                         45.7 45.8
                 anastomosis of intestine intestine




                 Other operations on
28   GENERAL                              Right hemicolectomy          45.73
                 intestine




                 Other operations on
29   GENERAL                              Transverse colectomy         45.74
                 intestine




                 Other operations on
30   GENERAL                              Left hemicolectomy           45.75
                 intestine




31   GENERAL     Colorectal surgery       Hartmann procedure




                 Operations on rectum,
32   GENERAL     rectosigmoid and         Sigmoidectomy                45.76
                 perirectal tissue




                                          Other colectomies
33   GENERAL     Colorectal surgery                                    45.79
                                          (incl. subtotal)




34   GENERAL     Colorectal surgery       Total colectomy
                                                                                                                                   % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                             Higher Incidence/Demand




                                                                                                                                                                                                                                                              Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                       Lower Incidence/Demand
                                                                                                                                                                      Improved Technique/T




                                                                                                                                                                                                                                           Higher Awareness
                                                                                                                                                                                                                          Growth/Greying
                                                                                    France 2004   France 2005   France 2006




                                                                                                                                                                                                                                                                   of Technique
     SURGICAL                                                         CODING




                                                                                                                                                                                                                            Population

                                                                                                                                                                                                                            Population
                                                                                                                                                                           echnology
ID                     CATEGORY               PROCEDURE                              Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                                                      (ICD-9-CM)                                                                          Tab for
                                                                                      Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                                                     Description of
                                                                                                                                                       Process)




35   GENERAL     Colorectal surgery       Total proctocolectomy




                 Incision, excision, and
36   GENERAL                              Intestinal anastomosis        45.9
                 anastomosis of intestine




37   GENERAL     Colorectal surgery       J-Pouch procedure         Part of 45.95




                 Other operations on
38   GENERAL                              Colostomy                     46.1
                 intestine




                 Other operations on
39   GENERAL                              Ileostomy                     46.2
                 intestine




40   GENERAL     Operations on appendix Appendectomy                    47.0




                                          Drainage of
41   GENERAL     Operations on appendix                                 47.2
                                          appendiceal abscess




                 Operations on rectum,
                                          Proctotomy, with and
42   GENERAL     rectosigmoid and                                       48.0
                                          without anterior repair
                 perirectal tissue




                                          Excision of rectal
43   GENERAL     Colorectal surgery                                    48.35
                                          adenoma
                                                                                                                                       % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                                 Higher Incidence/Demand




                                                                                                                                                                                                                                                                  Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                           Lower Incidence/Demand
                                                                                                                                                                          Improved Technique/T




                                                                                                                                                                                                                                               Higher Awareness
                                                                                                                                                                                                                              Growth/Greying
                                                                                      France 2004     France 2005   France 2006




                                                                                                                                                                                                                                                                       of Technique
     SURGICAL                                                           CODING




                                                                                                                                                                                                                                Population

                                                                                                                                                                                                                                Population
                                                                                                                                                                               echnology
ID                     CATEGORY               PROCEDURE                                Procedure       Procedure     Procedure                           (See Methods
     SPECIALTY                                                        (ICD-9-CM)                                                                            Tab for
                                                                                        Volumes         Volumes       Volumes     % Change '06 vs. '05
                                                                                                                                                         Description of
                                                                                                                                                           Process)




                                         Reduction of rectal
44   GENERAL     Colorectal surgery
                                         mucosa




                 Operations on rectum,
                                         Abdomino-perineal
45   GENERAL     rectosigmoid and                                         48.5
                                         resection of anus
                 perirectal tissue




46   GENERAL     Colorectal surgery      Low anterior resection       Part of 48.63




47   GENERAL     Colorectal surgery      Rectopexy                    48.76 48.75




                                         Procedures on
48   GENERAL     Operations on anus                                       49.4        Not available
                                         Hemorrhoids




                                         Destruction of
49   GENERAL     Operations on anus                                   49.43, 49.44
                                         Hemorrhoids




50   GENERAL     Operations on anus      Hemorrhoidectomy                49.46




                                         Implantation of artificial
51   GENERAL     Colorectal surgery
                                         anal sphincter




                                         Division of anal
52   GENERAL     Operations on anus                                       49.5
                                         sphincter
                                                                                                                                 % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                           Higher Incidence/Demand




                                                                                                                                                                                                                                                            Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                     Lower Incidence/Demand
                                                                                                                                                                    Improved Technique/T




                                                                                                                                                                                                                                         Higher Awareness
                                                                                                                                                                                                                        Growth/Greying
                                                                                  France 2004   France 2005   France 2006




                                                                                                                                                                                                                                                                 of Technique
     SURGICAL                                                         CODING




                                                                                                                                                                                                                          Population

                                                                                                                                                                                                                          Population
                                                                                                                                                                         echnology
ID                     CATEGORY                PROCEDURE                           Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                                                      (ICD-9-CM)                                                                        Tab for
                                                                                    Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                                                   Description of
                                                                                                                                                     Process)




53   GENERAL     Operations on anus        Repair of anus              49.7




                                           Other repair of anal
54   GENERAL     Colorectal surgery                                    49.79
                                           sphincter




55   GENERAL     Operations on liver       Hepatotomy                  50.0




                                           Hepatectomy (partial +
56   GENERAL     Operations on liver                                50.22 50.4
                                           complete)




57   GENERAL     Operations on liver       Lobectomy of liver          50.3




58   GENERAL     Operations on liver       Liver transplant            50.5




                 Operations on
59   GENERAL     gallbladder and biliary   Cholecystectomy             51.2
                 tract




                 Operations on
60   GENERAL     gallbladder and biliary   Open cholecystectomy     51.21 51.22
                 tract




                 Operations on
                                           Laparoscopic
61   GENERAL     gallbladder and biliary                            51.23 51.24
                                           cholecystectomy
                 tract
                                                                                                                                  % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                            Higher Incidence/Demand




                                                                                                                                                                                                                                                             Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                      Lower Incidence/Demand
                                                                                                                                                                     Improved Technique/T




                                                                                                                                                                                                                                          Higher Awareness
                                                                                                                                                                                                                         Growth/Greying
                                                                                   France 2004   France 2005   France 2006




                                                                                                                                                                                                                                                                  of Technique
     SURGICAL                                                           CODING




                                                                                                                                                                                                                           Population

                                                                                                                                                                                                                           Population
                                                                                                                                                                          echnology
ID                     CATEGORY                PROCEDURE                            Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                                                        (ICD-9-CM)                                                                       Tab for
                                                                                     Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                                                    Description of
                                                                                                                                                      Process)




                 Operations on
                                           Anastomosis of
62   GENERAL     gallbladder and biliary                                 51.3
                                           gallbladder or bile duct
                 tract



                 Operations on
                                           Pancreatectomy -
63   GENERAL     gallbladder and biliary                                52.52
                                           distal
                 tract




                                           Repair of inguinal
64   GENERAL     Repair of hernia                                     53.0 53.1
                                           hernia




                                           Inguinal herniorrhaphy,
65   GENERAL     Repair of hernia
                                           laparoscopic




                                           Inguinal herniorrhaphy,
66   GENERAL     Repair of hernia
                                           open




                                           Repair of femoral
67   GENERAL     Repair of hernia                                     53.2 53.3
                                           hernia




                                           Repair of recurrent
68   GENERAL     Repair of hernia          inguinal or femoral
                                           hernia




                                           Repair of umbilical
69   GENERAL     Repair of hernia                                        53.4
                                           hernia




                                           Repair of incisional
70   GENERAL     Repair of hernia                                       53.51
                                           hernia
                                                                                                                                      % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                                Higher Incidence/Demand




                                                                                                                                                                                                                                                                 Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                          Lower Incidence/Demand
                                                                                                                                                                         Improved Technique/T




                                                                                                                                                                                                                                              Higher Awareness
                                                                                                                                                                                                                             Growth/Greying
                                                                                     France 2004     France 2005   France 2006




                                                                                                                                                                                                                                                                      of Technique
     SURGICAL                                                          CODING




                                                                                                                                                                                                                               Population

                                                                                                                                                                                                                               Population
                                                                                                                                                                              echnology
ID                    CATEGORY                  PROCEDURE                             Procedure       Procedure     Procedure                           (See Methods
     SPECIALTY                                                       (ICD-9-CM)                                                                            Tab for
                                                                                       Volumes         Volumes       Volumes     % Change '06 vs. '05
                                                                                                                                                        Description of
                                                                                                                                                          Process)




                 Other operations on
71   GENERAL                                Exploratory laparotomy      54.11
                 abdominal region




                 Other operations on        Lysis of peritoneal
72   GENERAL                                                             54.5
                 abdominal region           adhesions




                 Operations on rectum,
                                            Repair of Cystocele
73   GENERAL     rectosigmoid and                                       70.50
                                            and Rectocele
                 perirectal tissue



                 Operations on rectum,
74   GENERAL     rectosigmoid and           Cystocele repair            70.51
                 perirectal tissue



                 Operations on rectum,
75   GENERAL     rectosigmoid and           Rectocele repair            70.52
                 perirectal tissue



                 Operations on rectum,
                                            Obliteration of the
76   GENERAL     rectosigmoid and                                        70.8        Not available
                                            vaginal vault
                 perirectal tissue



                 Operations on rectum,
77   GENERAL     rectosigmoid and           Enterocele repair        Part of 70.92
                 perirectal tissue




78   GENERAL     Operations on the breast Breast biopsy, needle         85.11




79   GENERAL     Operations on the breast Breast biopsy, open           85.12




                                            Removal breast
80   GENERAL     Operations on the breast
                                            tumour
                                                                                                                                       % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                                                                 Higher Incidence/Demand




                                                                                                                                                                                                                                                                  Lower Acceptance/Usage


                                                                                                                                                                                                                                                                                           Lower Incidence/Demand
                                                                                                                                                                          Improved Technique/T




                                                                                                                                                                                                                                               Higher Awareness
                                                                                                                                                                                                                              Growth/Greying
                                                                                        France 2004   France 2005   France 2006




                                                                                                                                                                                                                                                                       of Technique
     SURGICAL                                                           CODING




                                                                                                                                                                                                                                Population

                                                                                                                                                                                                                                Population
                                                                                                                                                                               echnology
ID                     CATEGORY                 PROCEDURE                                Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                                                        (ICD-9-CM)                                                                            Tab for
                                                                                          Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                                                         Description of
                                                                                                                                                           Process)




                                            Removal lesion of
81   GENERAL     Operations on the breast                                85.21
                                            breast - lumpectomy




82   GENERAL     Operations on the breast Breast reduction            85.31 85.32




                                            Subcutaneous              85.33, 85.34
83   GENERAL     Operations on the breast
                                            mastectomy                85.35, 85.36




84   GENERAL     Operations on the breast Mastectomy                     85.4




                                            Simple mastectomy      85.41 85.42 + part
85   GENERAL     Operations on the breast
                                            (total mastectomy)      of 85.43 & 85.44




                                            Modified radical             Part of
86   GENERAL     Operations on the breast
                                            mastectomy               85.43 & 85.44




                                                                      85.45 85.46
87   GENERAL     Operations on the breast Radical mastectomy
                                                                      85.47 85.48




88   GENERAL     Bariatric surgery          Abdominoplasty           Part of 86.83




                 Operations on rectum,
89   GENERAL     rectosigmoid and           Sacro-colpo-fixation
                 perirectal tissue
                                                                                                    % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                              Higher Incidence/Demand




                                                                                                                                                                                                                               Lower Acceptance/Usage


                                                                                                                                                                                                                                                        Lower Incidence/Demand
                                                                                                                                       Improved Technique/T




                                                                                                                                                                                                            Higher Awareness
                                                                                                                                                                                           Growth/Greying
                                                     France 2004   France 2005   France 2006




                                                                                                                                                                                                                                    of Technique
     SURGICAL                             CODING




                                                                                                                                                                                             Population

                                                                                                                                                                                             Population
                                                                                                                                            echnology
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                       Tab for
                                                       Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                      Description of
                                                                                                                        Process)
                                                                                                    % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                              Higher Incidence/Demand




                                                                                                                                                                                                                               Lower Acceptance/Usage


                                                                                                                                                                                                                                                        Lower Incidence/Demand
                                                                                                                                       Improved Technique/T




                                                                                                                                                                                                            Higher Awareness
                                                                                                                                                                                           Growth/Greying
                                                     France 2004   France 2005   France 2006




                                                                                                                                                                                                                                    of Technique
     SURGICAL                             CODING




                                                                                                                                                                                             Population

                                                                                                                                                                                             Population
                                                                                                                                            echnology
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                       Tab for
                                                       Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                      Description of
                                                                                                                        Process)
                                                                                                    % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                              Higher Incidence/Demand




                                                                                                                                                                                                                               Lower Acceptance/Usage


                                                                                                                                                                                                                                                        Lower Incidence/Demand
                                                                                                                                       Improved Technique/T




                                                                                                                                                                                                            Higher Awareness
                                                                                                                                                                                           Growth/Greying
                                                     France 2004   France 2005   France 2006




                                                                                                                                                                                                                                    of Technique
     SURGICAL                             CODING




                                                                                                                                                                                             Population

                                                                                                                                                                                             Population
                                                                                                                                            echnology
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                       Tab for
                                                       Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                      Description of
                                                                                                                        Process)
                                                                                                    % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                              Higher Incidence/Demand




                                                                                                                                                                                                                               Lower Acceptance/Usage


                                                                                                                                                                                                                                                        Lower Incidence/Demand
                                                                                                                                       Improved Technique/T




                                                                                                                                                                                                            Higher Awareness
                                                                                                                                                                                           Growth/Greying
                                                     France 2004   France 2005   France 2006




                                                                                                                                                                                                                                    of Technique
     SURGICAL                             CODING




                                                                                                                                                                                             Population

                                                                                                                                                                                             Population
                                                                                                                                            echnology
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                       Tab for
                                                       Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                      Description of
                                                                                                                        Process)
                                                                                                    % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                              Higher Incidence/Demand




                                                                                                                                                                                                                               Lower Acceptance/Usage


                                                                                                                                                                                                                                                        Lower Incidence/Demand
                                                                                                                                       Improved Technique/T




                                                                                                                                                                                                            Higher Awareness
                                                                                                                                                                                           Growth/Greying
                                                     France 2004   France 2005   France 2006




                                                                                                                                                                                                                                    of Technique
     SURGICAL                             CODING




                                                                                                                                                                                             Population

                                                                                                                                                                                             Population
                                                                                                                                            echnology
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                       Tab for
                                                       Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                      Description of
                                                                                                                        Process)
                                                                                                    % Change             Process                                                        Confirmed Trend                                                                          Other




                                                                                                                                                              Higher Incidence/Demand




                                                                                                                                                                                                                               Lower Acceptance/Usage


                                                                                                                                                                                                                                                        Lower Incidence/Demand
                                                                                                                                       Improved Technique/T




                                                                                                                                                                                                            Higher Awareness
                                                                                                                                                                                           Growth/Greying
                                                     France 2004   France 2005   France 2006




                                                                                                                                                                                                                                    of Technique
     SURGICAL                             CODING




                                                                                                                                                                                             Population

                                                                                                                                                                                             Population
                                                                                                                                            echnology
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure                           (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                       Tab for
                                                       Volumes       Volumes       Volumes     % Change '06 vs. '05
                                                                                                                      Description of
                                                                                                                        Process)
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                          Procedure Subgroups    SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                                                National Databank and National
                                                                         organisations




                                                                National Databank and National
                                                                         organisations




                                                                National Databank and National
                                                                         organisations




                                                                National Databank and National
                                                                         organisations




                                                                National Databank and National
                                                                         organisations




                                                                National Databank and National
                                                                         organisations




                                                                National Databank and National
                                                                         organisations
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                          Procedure Subgroups      SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                                                 National Databank and National
                                                                          organisations




                                                                    National Databank, National
                                                                organisations and Expert Interviews




                                                                 National Databank and National
                                                                          organisations




                                                                 National Databank and National
                                                                          organisations




                                                                 National Databank and National
                                                                          organisations




                                                                 National Databank and National
                                                                          organisations




                                                                 National Databank and National
                                                                          organisations




                                                                 National Databank and National
                                                                          organisations




                                                                 National Databank and National
                                                                          organisations
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                                 Procedure Subgroups                 SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                            The Laparoscopic Gastric Bypass
                                             procedures are a subset of the       National Organisations and Opinion
                                          Gastroenterostomy without gastrectomy                Leaders
                                                    procedures (44.3)




                                            The Laparoscopic Gastric Bypass
                                             procedures are a subset of the        National Databank and National
                                          Gastroenterostomy without gastrectomy             organisations
                                                    procedures (44.3)




                                                                                   National Databank and National
                                                                                            organisations




                                                                                      National Databank, National
                                                                                  organisations and Expert Interviews




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                                  Procedure Subgroups                     SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                                                                        National Databank and National
                                                                                                 organisations




                                                                                        National Databank and National
                                                                                                 organisations




                                          The Right hemicolectomies (45.73) are
                                                                                        National Databank and National
                                            a subset of the Excisions of large
                                                                                                 organisations
                                                   Intestine (45.7 45.8)




                                          The Transverse colectomies (45.74) are
                                                                                        National Databank and National
                                             a subset of the Excisions of large
                                                                                                 organisations
                                                   Intestine (45.7 45.8)




                                           The Left hemicolectomies (45.75) are a
                                                                                        National Databank and National
                                          subset of the Excisions of large Intestine
                                                                                                 organisations
                                                         (45.7 45.8)




                                                                                           National Databank, National
                                                                                       organisations and Expert Interviews




                                            The Sigmoidectomies (45.76) are a
                                                                                        National Databank and National
                                          subset of the Excisions of large Intestine
                                                                                                 organisations
                                                         (45.7 45.8)




                                            The Other colectomies (45.79) are a
                                                                                        National Databank and National
                                          subset of the Excisions of large Intestine
                                                                                                 organisations
                                                         (45.7 45.8)




                                                                                        National Databank and National
                                                                                                 organisations
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                                 Procedure Subgroups                  SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                                                                    National Databank and National
                                                                                             organisations




                                                                                       National Databank, National
                                                                                   organisations and Expert Interviews




                                          The J-Pouch procedures are a subset of
                                                                                    National Databank and National
                                           the Intestinal Anastomosis procedures
                                                                                             organisations
                                                            (45.9)




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                                 Procedure Subgroups                SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                               The Destruction of hemorrhoids
                                          procedures (49.43, 49.44) are a subset   National Databank and National
                                          of the Total Procedures on hemorrhoids            organisations
                                                           (49.4)




                                           he Hemorrhoidectomies (49.46) are a
                                                                                   National Databank and National
                                             subset of the Total procedures on
                                                                                            organisations
                                                    hemorrhoids (49.4).




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                                 Procedure Subgroups                  SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                                                                    National Databank and National
                                                                                             organisations




                                            The Other repair of anal sphincter
                                                                                    National Databank and National
                                          Procedures (49.79) are a subset of the
                                                                                             organisations
                                            Repair of Anus Procedures (49.7)




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations




                                                                                       National Databank, National
                                                                                   organisations and Expert Interviews




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations




                                          The Open Cholecystectomy Procedures
                                                                                    National Databank and National
                                             (51.21 51.22) are a subset of all
                                                                                             organisations
                                                Cholecystectomies (51.2)




                                           The Laparoscopic cholecystectomies
                                                                                    National Databank and National
                                             (51.23 51.24) are a subset of all
                                                                                             organisations
                                                Cholecystectomies (51.2)
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                                  Procedure Subgroups                     SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                                                                        National Databank and National
                                                                                                 organisations




                                                                                           National Databank, National
                                                                                       organisations and Expert Interviews




                                                                                        National Databank and National
                                                                                                 organisations




                                                The Laparoscopic Inguinal
                                                                                        National Databank and National
                                          Herniorrhaphy Procedures are a subset
                                                                                                 organisations
                                          of Repair of inguinal hernia (53.0, 53.1).




                                            The Open Inguinal Herniorrhaphy
                                                                                        National Databank and National
                                           Procedures are a subset of Repair of
                                                                                                 organisations
                                               inguinal hernia (53.0, 53.1).




                                                                                        National Databank and National
                                                                                                 organisations




                                                                                        National Databank and National
                                                                                                 organisations




                                                                                        National Databank and National
                                                                                                 organisations




                                                                                        National Databank and National
                                                                                                 organisations
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                                 Procedure Subgroups                   SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                                                                     National Databank and National
                                                                                              organisations




                                                                                        National Databank, National
                                                                                    organisations and Expert Interviews




                                          The Cystocele/rectocele repairs (70.50)
                                                                                        National Databank, National
                                           are a subset of the Repair of prolapse
                                                                                    organisations and Expert Interviews
                                                        procedures



                                           The Cystocele repairs (70.51) are a
                                                                                     National Databank and National
                                            subset of the Repair of prolapse
                                                                                              organisations
                                                       procedures



                                           The Rectocele repairs (70.52) are a
                                                                                     National Databank and National
                                            subset of the Repair of prolapse
                                                                                              organisations
                                                       procedures




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                        National Databank, National
                                                                                    organisations and Expert Interviews
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                                  Procedure Subgroups                  SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes




                                          The Lumpectomies (85.21) are a subset
                                                                                     National Databank and National
                                             of the Removal of breast tumour
                                                                                              organisations
                                                       procedures.




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                          The Mastectomies (85.4) are a subset of
                                                                                     National Databank and National
                                              the Removal of breast tumour
                                                                                              organisations
                                                      procedures.




                                          The Simple mastectomies are a subset       National Databank and National
                                               of the Mastectomies (85.4)                     organisations




                                          The Modified radical mastectomies are      National Databank and National
                                           a subset of the Mastectomies (85.4)                organisations




                                          The Radical mastectomies are a subset         National Databank, National
                                               of the Mastectomies (85.4)           organisations and Expert Interviews




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                          Procedure Subgroups   SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                          Procedure Subgroups   SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                          Procedure Subgroups   SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                          Procedure Subgroups   SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                          Procedure Subgroups   SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes
FORECAST:     FORECAST:     FORECAST:
France 2007   France 2008   France 2009
                                          Procedure Subgroups   SOURCES/ASSUMPTIONS
 Procedure     Procedure     Procedure
  Volumes       Volumes       Volumes
                                                                                                                                 % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                      Lower acceptance/Usage of
                                                                                                                                                                                                                       Population growth/Greying
                                                                                                                                                                                          Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                  Lower incidence/Demand
                                                                                                                                                                    Improved Technique/




                                                                                                                                                                                                                                                   Higher Awareness
                                                                              Germany 2004    Germany 2005   Germany 2006




                                                                                                                                                                        Technology
     SURGICAL                                                      CODING




                                                                                                                                                                                                                               population




                                                                                                                                                                                                                                                                              technique
ID                    CATEGORY                PROCEDURE                        Procedure       Procedure      Procedure                            (See Methods
     SPECIALTY                                                   (ICD-9-CM)                                                                           Tab for
                                                                                Volumes         Volumes        Volumes      % Change '06 vs. '05
                                                                                                                                                   Description of
                                                                                                                                                     Process)




                 Operations on thyroid    Unilateral thyroid
1    GENERAL                                                        06.2
                 and parathyroid glands   lobectomy




                 Operations on thyroid    Complete
2    GENERAL                                                        06.4
                 and parathyroid glands   thyroidectomy




                 Operations on thyroid
3    GENERAL                              Parathyroidectomy         06.8
                 and parathyroid glands




                 Operations on other
4    GENERAL                              Total adrenalectomy       07.3
                 endocrine glands




                 Operations on other
5    GENERAL                              Hypophysectomy            07.6
                 endocrine glands




                 Operations on lymphatic Incision of lymphatic
6    GENERAL                                                        40.0
                 system                  structures




                 Operations on lymphatic Biopsy of lymphatic
7    GENERAL                                                       40.11      Not available
                 system                  structure
                                                                                                                                 % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                      Lower acceptance/Usage of
                                                                                                                                                                                                                       Population growth/Greying
                                                                                                                                                                                          Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                  Lower incidence/Demand
                                                                                                                                                                    Improved Technique/




                                                                                                                                                                                                                                                   Higher Awareness
                                                                               Germany 2004   Germany 2005   Germany 2006




                                                                                                                                                                        Technology
     SURGICAL                                                    CODING




                                                                                                                                                                                                                               population




                                                                                                                                                                                                                                                                              technique
ID                     CATEGORY              PROCEDURE                          Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                                                 (ICD-9-CM)                                                                             Tab for
                                                                                 Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                                                   Description of
                                                                                                                                                     Process)




                 Operations on lymphatic                        40.2 40.3
8    GENERAL                             Lymphadenectomy
                 system                                         40.4 40.5




                                        Bone marrow or
                 Operations on bone
9    GENERAL                            hematopoietic stem         41.0
                 marrow and spleen
                                        cell transplant




                 Operations on bone
10   GENERAL                            Splenectomy             41.43 41.5
                 marrow and spleen




                 Operations on
11   GENERAL                            Esophagectomy              42.4
                 esophagus




                 Operations on
12   GENERAL                            Esophagomyotomy            42.7
                 esophagus




                 Incision and excision of
13   GENERAL                              Gastrotomy               43.0
                 stomach




                 Incision and excision of
14   GENERAL                              Pyloromyotomy            43.3
                 stomach




                                        Open extirpation of
15   GENERAL     Bariatric surgery
                                        lesion of stomach




                 Incision and excision of                     43.5 43.6 43.7
16   GENERAL                              Gastrectomy
                 stomach                                         43.8 43.9
                                                                                                                                       % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                            Lower acceptance/Usage of
                                                                                                                                                                                                                             Population growth/Greying
                                                                                                                                                                                                Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                        Lower incidence/Demand
                                                                                                                                                                          Improved Technique/




                                                                                                                                                                                                                                                         Higher Awareness
                                                                                  Germany 2004    Germany 2005    Germany 2006




                                                                                                                                                                              Technology
     SURGICAL                                                       CODING




                                                                                                                                                                                                                                     population




                                                                                                                                                                                                                                                                                    technique
ID                     CATEGORY               PROCEDURE                            Procedure       Procedure       Procedure                             (See Methods
     SPECIALTY                                                    (ICD-9-CM)                                                                                Tab for
                                                                                    Volumes         Volumes         Volumes       % Change '06 vs. '05
                                                                                                                                                         Description of
                                                                                                                                                           Process)




                 Incision and excision of
17   GENERAL                              Vagotomy                    44.0
                 stomach




                                          Gastroenterostomy
                 Incision and excision of
18   GENERAL                              without gastrectomy         44.3
                 stomach
                                          (gastric bypass)




                                          Gastric Bypass,
19   GENERAL     Bariatric surgery
                                          laparoscopic




20   GENERAL     Bariatric surgery        Gastric Bypass, open




                 Operations on
21   GENERAL                              Fundoplication          Part of 44.66
                 esophagus




22   GENERAL     Bariatric surgery        Gastroplasty            44.68 44.69     Not available   Not available   Not available




                                          (Laparoscopic)
                                          adjustment of size of
23   GENERAL     Bariatric Surgery                                   44.98        Not available
                                          adjustable gastric
                                          restrictive device



                 Incision, excision, and
24   GENERAL                              Enterotomy                  45.0
                 anastomosis of intestine




                 Incision, excision, and  Excision of small
25   GENERAL                                                       45.3, 45.63
                 anastomosis of intestine intestine
                                                                                                                                        % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                             Lower acceptance/Usage of
                                                                                                                                                                                                                              Population growth/Greying
                                                                                                                                                                                                 Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                         Lower incidence/Demand
                                                                                                                                                                           Improved Technique/




                                                                                                                                                                                                                                                          Higher Awareness
                                                                                      Germany 2004   Germany 2005   Germany 2006




                                                                                                                                                                               Technology
     SURGICAL                                                          CODING




                                                                                                                                                                                                                                      population




                                                                                                                                                                                                                                                                                     technique
ID                    CATEGORY                PROCEDURE                                Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                                                       (ICD-9-CM)                                                                              Tab for
                                                                                        Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                                                          Description of
                                                                                                                                                            Process)




                 Incision, excision, and
26   GENERAL                              Small bowel resection   45.61 45.62 45.51
                 anastomosis of intestine




                 Incision, excision, and  Excision of large
27   GENERAL                                                         45.7 45.8
                 anastomosis of intestine intestine




                 Other operations on
28   GENERAL                              Right hemicolectomy          45.73
                 intestine




                 Other operations on
29   GENERAL                              Transverse colectomy         45.74
                 intestine




                 Other operations on
30   GENERAL                              Left hemicolectomy           45.75
                 intestine




31   GENERAL     Colorectal surgery       Hartmann procedure




                 Operations on rectum,
32   GENERAL     rectosigmoid and         Sigmoidectomy                45.76
                 perirectal tissue




                                          Other colectomies
33   GENERAL     Colorectal surgery                                    45.79
                                          (incl. subtotal)




34   GENERAL     Colorectal surgery       Total colectomy
                                                                                                                                      % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                           Lower acceptance/Usage of
                                                                                                                                                                                                                            Population growth/Greying
                                                                                                                                                                                               Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                       Lower incidence/Demand
                                                                                                                                                                         Improved Technique/




                                                                                                                                                                                                                                                        Higher Awareness
                                                                                    Germany 2004   Germany 2005   Germany 2006




                                                                                                                                                                             Technology
     SURGICAL                                                         CODING




                                                                                                                                                                                                                                    population




                                                                                                                                                                                                                                                                                   technique
ID                    CATEGORY                PROCEDURE                              Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                                                      (ICD-9-CM)                                                                             Tab for
                                                                                      Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                                                        Description of
                                                                                                                                                          Process)




35   GENERAL     Colorectal surgery       Total proctocolectomy




                 Incision, excision, and
36   GENERAL                              Intestinal anastomosis        45.9
                 anastomosis of intestine




37   GENERAL     Colorectal surgery       J-Pouch procedure         Part of 45.95




                 Other operations on
38   GENERAL                              Colostomy                     46.1
                 intestine




                 Other operations on
39   GENERAL                              Ileostomy                     46.2
                 intestine




40   GENERAL     Operations on appendix Appendectomy                    47.0




                                          Drainage of
41   GENERAL     Operations on appendix                                 47.2
                                          appendiceal abscess




                 Operations on rectum,
                                          Proctotomy, with and
42   GENERAL     rectosigmoid and                                       48.0
                                          without anterior repair
                 perirectal tissue




                                          Excision of rectal
43   GENERAL     Colorectal surgery                                    48.35
                                          adenoma
                                                                                                                                        % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                             Lower acceptance/Usage of
                                                                                                                                                                                                                              Population growth/Greying
                                                                                                                                                                                                 Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                         Lower incidence/Demand
                                                                                                                                                                           Improved Technique/




                                                                                                                                                                                                                                                          Higher Awareness
                                                                                     Germany 2004    Germany 2005   Germany 2006




                                                                                                                                                                               Technology
     SURGICAL                                                          CODING




                                                                                                                                                                                                                                      population




                                                                                                                                                                                                                                                                                     technique
ID                    CATEGORY               PROCEDURE                                Procedure       Procedure      Procedure                            (See Methods
     SPECIALTY                                                       (ICD-9-CM)                                                                              Tab for
                                                                                       Volumes         Volumes        Volumes      % Change '06 vs. '05
                                                                                                                                                          Description of
                                                                                                                                                            Process)




                                         Reduction of rectal
44   GENERAL     Colorectal surgery
                                         mucosa




                 Operations on rectum,
                                         Abdomino-perineal
45   GENERAL     rectosigmoid and                                        48.5
                                         resection of anus
                 perirectal tissue




46   GENERAL     Colorectal surgery      Low anterior resection      Part of 48.63




47   GENERAL     Colorectal surgery      Rectopexy                   48.76 48.75




                                         Procedures on
48   GENERAL     Operations on anus                                      49.4        Not available
                                         Hemorrhoids




                                         Destruction of
49   GENERAL     Operations on anus                                  49.43, 49.44
                                         Hemorrhoids




50   GENERAL     Operations on anus      Hemorrhoidectomy               49.46




                                         Implantation of
51   GENERAL     Colorectal surgery
                                         artificial anal sphincter




                                         Division of anal
52   GENERAL     Operations on anus                                      49.5
                                         sphincter
                                                                                                                                    % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                         Lower acceptance/Usage of
                                                                                                                                                                                                                          Population growth/Greying
                                                                                                                                                                                             Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                     Lower incidence/Demand
                                                                                                                                                                       Improved Technique/




                                                                                                                                                                                                                                                      Higher Awareness
                                                                                  Germany 2004   Germany 2005   Germany 2006




                                                                                                                                                                           Technology
     SURGICAL                                                         CODING




                                                                                                                                                                                                                                  population




                                                                                                                                                                                                                                                                                 technique
ID                     CATEGORY                PROCEDURE                           Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                                                      (ICD-9-CM)                                                                           Tab for
                                                                                    Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                                                      Description of
                                                                                                                                                        Process)




53   GENERAL     Operations on anus        Repair of anus              49.7




                                           Other repair of anal
54   GENERAL     Colorectal surgery                                    49.79
                                           sphincter




55   GENERAL     Operations on liver       Hepatotomy                  50.0




                                           Hepatectomy (partial +
56   GENERAL     Operations on liver                                50.22 50.4
                                           complete)




57   GENERAL     Operations on liver       Lobectomy of liver          50.3




58   GENERAL     Operations on liver       Liver transplant            50.5




                 Operations on
59   GENERAL     gallbladder and biliary   Cholecystectomy             51.2
                 tract



                 Operations on
60   GENERAL     gallbladder and biliary   Open cholecystectomy     51.21 51.22
                 tract



                 Operations on
                                           Laparoscopic
61   GENERAL     gallbladder and biliary                            51.23 51.24
                                           cholecystectomy
                 tract
                                                                                                                                     % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                          Lower acceptance/Usage of
                                                                                                                                                                                                                           Population growth/Greying
                                                                                                                                                                                              Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                      Lower incidence/Demand
                                                                                                                                                                        Improved Technique/




                                                                                                                                                                                                                                                       Higher Awareness
                                                                                   Germany 2004   Germany 2005   Germany 2006




                                                                                                                                                                            Technology
     SURGICAL                                                           CODING




                                                                                                                                                                                                                                   population




                                                                                                                                                                                                                                                                                  technique
ID                     CATEGORY                PROCEDURE                            Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                                                        (ICD-9-CM)                                                                          Tab for
                                                                                     Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                                                       Description of
                                                                                                                                                         Process)




                 Operations on
                                           Anastomosis of
62   GENERAL     gallbladder and biliary                                 51.3
                                           gallbladder or bile duct
                 tract



                 Operations on
                                           Pancreatectomy -
63   GENERAL     gallbladder and biliary                                52.52
                                           distal
                 tract




                                           Repair of inguinal
64   GENERAL     Repair of hernia                                     53.0 53.1
                                           hernia




                                           Inguinal
65   GENERAL     Repair of hernia          herniorrhaphy,
                                           laparoscopic




                                           Inguinal
66   GENERAL     Repair of hernia
                                           herniorrhaphy, open




                                           Repair of femoral
67   GENERAL     Repair of hernia                                     53.2 53.3
                                           hernia




                                           Repair of recurrent
68   GENERAL     Repair of hernia          inguinal or femoral
                                           hernia




                                           Repair of umbilical
69   GENERAL     Repair of hernia                                        53.4
                                           hernia




                                           Repair of incisional
70   GENERAL     Repair of hernia                                       53.51
                                           hernia
                                                                                                                                    % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                         Lower acceptance/Usage of
                                                                                                                                                                                                                          Population growth/Greying
                                                                                                                                                                                             Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                     Lower incidence/Demand
                                                                                                                                                                       Improved Technique/




                                                                                                                                                                                                                                                      Higher Awareness
                                                                                 Germany 2004    Germany 2005   Germany 2006




                                                                                                                                                                           Technology
     SURGICAL                                                      CODING




                                                                                                                                                                                                                                  population




                                                                                                                                                                                                                                                                                 technique
ID                    CATEGORY               PROCEDURE                            Procedure       Procedure      Procedure                            (See Methods
     SPECIALTY                                                   (ICD-9-CM)                                                                              Tab for
                                                                                   Volumes         Volumes        Volumes      % Change '06 vs. '05
                                                                                                                                                      Description of
                                                                                                                                                        Process)




                 Other operations on     Exploratory
71   GENERAL                                                        54.11
                 abdominal region        laparotomy




                 Other operations on     Lysis of peritoneal
72   GENERAL                                                         54.5
                 abdominal region        adhesions




                 Operations on rectum,
                                         Repair of Cystocele
73   GENERAL     rectosigmoid and                                   70.50
                                         and Rectocele
                 perirectal tissue




                 Operations on rectum,
74   GENERAL     rectosigmoid and        Cystocele repair           70.51
                 perirectal tissue




                 Operations on rectum,
75   GENERAL     rectosigmoid and        Rectocele repair           70.52
                 perirectal tissue




                 Operations on rectum,
                                         Obliteration of the
76   GENERAL     rectosigmoid and                                    70.8        Not available
                                         vaginal vault
                 perirectal tissue



                 Operations on rectum,
77   GENERAL     rectosigmoid and        Enterocele repair       Part of 70.92
                 perirectal tissue




                 Operations on the
78   GENERAL                             Breast biopsy, needle      85.11
                 breast




                 Operations on the
79   GENERAL                             Breast biopsy, open        85.12
                 breast




                 Operations on the       Removal breast
80   GENERAL                                                                     Not available
                 breast                  tumour
                                                                                                                                       % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                                                            Lower acceptance/Usage of
                                                                                                                                                                                                                             Population growth/Greying
                                                                                                                                                                                                Higher Incidence/ demand




                                                                                                                                                                                                                                                                                                        Lower incidence/Demand
                                                                                                                                                                          Improved Technique/




                                                                                                                                                                                                                                                         Higher Awareness
                                                                                     Germany 2004   Germany 2005   Germany 2006




                                                                                                                                                                              Technology
     SURGICAL                                                        CODING




                                                                                                                                                                                                                                     population




                                                                                                                                                                                                                                                                                    technique
ID                     CATEGORY              PROCEDURE                                Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                                                     (ICD-9-CM)                                                                               Tab for
                                                                                       Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                                                         Description of
                                                                                                                                                           Process)




                 Operations on the       Removal lesion of
81   GENERAL                                                          85.21
                 breast                  breast - lumpectomy




                 Operations on the
82   GENERAL                             Breast reduction          85.31 85.32
                 breast




                 Operations on the       Subcutaneous              85.33, 85.34
83   GENERAL
                 breast                  mastectomy                85.35, 85.36




                 Operations on the
84   GENERAL                             Mastectomy                   85.4
                 breast




                 Operations on the       Simple mastectomy      85.41 85.42 + part
85   GENERAL
                 breast                  (total mastectomy)      of 85.43 & 85.44




                 Operations on the       Modified radical             Part of
86   GENERAL
                 breast                  mastectomy               85.43 & 85.44




                 Operations on the                                 85.45 85.46
87   GENERAL                             Radical mastectomy
                 breast                                            85.47 85.48




88   GENERAL     Bariatric surgery       Abdominoplasty           Part of 86.83




                 Operations on rectum,
89   GENERAL     rectosigmoid and        Sacro-colpo-fixation
                 perirectal tissue
                                                                                                       % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                            Lower acceptance/Usage of
                                                                                                                                                                                             Population growth/Greying
                                                                                                                                                                Higher Incidence/ demand




                                                                                                                                                                                                                                                                        Lower incidence/Demand
                                                                                                                                          Improved Technique/




                                                                                                                                                                                                                         Higher Awareness
                                                     Germany 2004   Germany 2005   Germany 2006




                                                                                                                                              Technology
     SURGICAL                             CODING




                                                                                                                                                                                                     population




                                                                                                                                                                                                                                                    technique
ID               CATEGORY   PROCEDURE                 Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                          Tab for
                                                       Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                         Description of
                                                                                                                           Process)
                                                                                                       % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                            Lower acceptance/Usage of
                                                                                                                                                                                             Population growth/Greying
                                                                                                                                                                Higher Incidence/ demand




                                                                                                                                                                                                                                                                        Lower incidence/Demand
                                                                                                                                          Improved Technique/




                                                                                                                                                                                                                         Higher Awareness
                                                     Germany 2004   Germany 2005   Germany 2006




                                                                                                                                              Technology
     SURGICAL                             CODING




                                                                                                                                                                                                     population




                                                                                                                                                                                                                                                    technique
ID               CATEGORY   PROCEDURE                 Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                          Tab for
                                                       Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                         Description of
                                                                                                                           Process)
                                                                                                       % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                            Lower acceptance/Usage of
                                                                                                                                                                                             Population growth/Greying
                                                                                                                                                                Higher Incidence/ demand




                                                                                                                                                                                                                                                                        Lower incidence/Demand
                                                                                                                                          Improved Technique/




                                                                                                                                                                                                                         Higher Awareness
                                                     Germany 2004   Germany 2005   Germany 2006




                                                                                                                                              Technology
     SURGICAL                             CODING




                                                                                                                                                                                                     population




                                                                                                                                                                                                                                                    technique
ID               CATEGORY   PROCEDURE                 Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                          Tab for
                                                       Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                         Description of
                                                                                                                           Process)
                                                                                                       % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                            Lower acceptance/Usage of
                                                                                                                                                                                             Population growth/Greying
                                                                                                                                                                Higher Incidence/ demand




                                                                                                                                                                                                                                                                        Lower incidence/Demand
                                                                                                                                          Improved Technique/




                                                                                                                                                                                                                         Higher Awareness
                                                     Germany 2004   Germany 2005   Germany 2006




                                                                                                                                              Technology
     SURGICAL                             CODING




                                                                                                                                                                                                     population




                                                                                                                                                                                                                                                    technique
ID               CATEGORY   PROCEDURE                 Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                          Tab for
                                                       Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                         Description of
                                                                                                                           Process)
                                                                                                       % Change            Process                                                         Confirmed Trend                                                                                       Other




                                                                                                                                                                                                                                            Lower acceptance/Usage of
                                                                                                                                                                                             Population growth/Greying
                                                                                                                                                                Higher Incidence/ demand




                                                                                                                                                                                                                                                                        Lower incidence/Demand
                                                                                                                                          Improved Technique/




                                                                                                                                                                                                                         Higher Awareness
                                                     Germany 2004   Germany 2005   Germany 2006




                                                                                                                                              Technology
     SURGICAL                             CODING




                                                                                                                                                                                                     population




                                                                                                                                                                                                                                                    technique
ID               CATEGORY   PROCEDURE                 Procedure      Procedure      Procedure                            (See Methods
     SPECIALTY                          (ICD-9-CM)                                                                          Tab for
                                                       Volumes        Volumes        Volumes      % Change '06 vs. '05
                                                                                                                         Description of
                                                                                                                           Process)
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                             Indication on Subgroups    SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                                                       National Databank and National
                                                                                organisations




                                                                       National Databank and National
                                                                                organisations




                                                                       National Databank and National
                                                                                organisations




                                                                       National Databank and National
                                                                                organisations




                                                                       National Databank and National
                                                                                organisations




                                                                       National Databank and National
                                                                                organisations




                                                                       National Databank and National
                                                                                organisations
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                             Indication on Subgroups      SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                                                        National Databank and National
                                                                                 organisations




                                                                           National Databank, National
                                                                       organisations and Expert Interviews




                                                                        National Databank and National
                                                                                 organisations




                                                                        National Databank and National
                                                                                 organisations




                                                                        National Databank and National
                                                                                 organisations




                                                                        National Databank and National
                                                                                 organisations




                                                                        National Databank and National
                                                                                 organisations




                                                                        National Databank and National
                                                                                 organisations




                                                                        National Databank and National
                                                                                 organisations
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                                Indication on Subgroups           SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                                                                National Databank and National
                                                                                         organisations




                                                                                National Databank and National
                                                                                         organisations




                                             The Laparoscopic Gastric Bypass
                                              procedures are a subset of the   National Organisations and Opinion
                                                Gastroenterostomy without                   Leaders
                                              gastrectomy procedures (44.3)




                                             The Laparoscopic Gastric Bypass
                                              procedures are a subset of the    National Databank and National
                                                Gastroenterostomy without                organisations
                                              gastrectomy procedures (44.3)




                                                                                National Databank and National
                                                                                         organisations




                                                                                   National Databank, National
                                                                               organisations and Expert Interviews




                                                                                National Databank and National
                                                                                         organisations




                                                                                National Databank and National
                                                                                         organisations




                                                                                National Databank and National
                                                                                         organisations
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                                 Indication on Subgroups              SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations




                                             The Right hemicolectomies (45.73)
                                                                                    National Databank and National
                                              are a subset of the Excisions of
                                                                                             organisations
                                                 large Intestine (45.7 45.8)



                                             The Transverse colectomies (45.74)
                                                                                    National Databank and National
                                               are a subset of the Excisions of
                                                                                             organisations
                                                  large Intestine (45.7 45.8)



                                              The Left hemicolectomies (45.75)
                                                                                    National Databank and National
                                               are a subset of the Excisions of
                                                                                             organisations
                                                  large Intestine (45.7 45.8)




                                                                                       National Databank, National
                                                                                   organisations and Expert Interviews




                                             The Sigmoidectomies (45.76) are a
                                                                                    National Databank and National
                                               subset of the Excisions of large
                                                                                             organisations
                                                    Intestine (45.7 45.8)



                                             The Other colectomies (45.79) are a
                                                                                    National Databank and National
                                               subset of the Excisions of large
                                                                                             organisations
                                                    Intestine (45.7 45.8)




                                                                                    National Databank and National
                                                                                             organisations
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                                 Indication on Subgroups               SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                                                                     National Databank and National
                                                                                              organisations




                                                                                        National Databank, National
                                                                                    organisations and Expert Interviews




                                                The J-Pouch procedures are a
                                                                                     National Databank and National
                                             subset of the Intestinal Anastomosis
                                                                                              organisations
                                                      procedures (45.9)




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                                 Indication on Subgroups            SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations




                                              The Destruction of hemorrhoids
                                              procedures (49.43, 49.44) are a      National Databank and National
                                             subset of the Total Procedures on              organisations
                                                    hemorrhoids (49.4)




                                             he Hemorrhoidectomies (49.46) are
                                                                                   National Databank and National
                                             a subset of the Total procedures on
                                                                                            organisations
                                                    hemorrhoids (49.4).




                                                                                   National Databank and National
                                                                                            organisations




                                                                                   National Databank and National
                                                                                            organisations
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                                 Indication on Subgroups              SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                                                                    National Databank and National
                                                                                             organisations




                                             The Other repair of anal sphincter
                                             Procedures (49.79) are a subset of     National Databank and National
                                               the Repair of Anus Procedures                 organisations
                                                           (49.7)




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations




                                                                                       National Databank, National
                                                                                   organisations and Expert Interviews




                                                                                    National Databank and National
                                                                                             organisations




                                                                                    National Databank and National
                                                                                             organisations



                                                 The Open Cholecystectomy
                                               Procedures (51.21 51.22) are a       National Databank and National
                                               subset of all Cholecystectomies               organisations
                                                             (51.2)


                                                      The Laparoscopic
                                             cholecystectomies (51.23 51.24) are    National Databank and National
                                              a subset of all Cholecystectomies              organisations
                                                             (51.2)
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                                  Indication on Subgroups              SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                                                                     National Databank and National
                                                                                              organisations




                                                                                        National Databank, National
                                                                                    organisations and Expert Interviews




                                                                                     National Databank and National
                                                                                              organisations



                                                 The Laparoscopic Inguinal
                                               Herniorrhaphy Procedures are a        National Databank and National
                                              subset of Repair of inguinal hernia             organisations
                                                         (53.0, 53.1).


                                              The Open Inguinal Herniorrhaphy
                                                                                     National Databank and National
                                             Procedures are a subset of Repair of
                                                                                              organisations
                                                 inguinal hernia (53.0, 53.1).




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                                 Indication on Subgroups                SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                                                                      National Databank and National
                                                                                               organisations




                                                                                         National Databank, National
                                                                                     organisations and Expert Interviews




                                               The Cystocele/rectocele repairs
                                                                                         National Databank, National
                                             (70.50) are a subset of the Repair of
                                                                                     organisations and Expert Interviews
                                                     prolapse procedures




                                             The Cystocele repairs (70.51) are a
                                                                                      National Databank and National
                                              subset of the Repair of prolapse
                                                                                               organisations
                                                         procedures




                                             The Rectocele repairs (70.52) are a
                                                                                      National Databank and National
                                              subset of the Repair of prolapse
                                                                                               organisations
                                                         procedures




                                                                                      National Databank and National
                                                                                               organisations




                                                                                      National Databank and National
                                                                                               organisations




                                                                                      National Databank and National
                                                                                               organisations




                                                                                      National Databank and National
                                                                                               organisations




                                                                                         National Databank, National
                                                                                     organisations and Expert Interviews
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                                Indication on Subgroups             SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes




                                              The Lumpectomies (85.21) are a
                                                                                  National Databank and National
                                              subset of the Removal of breast
                                                                                           organisations
                                                    tumour procedures.




                                                                                  National Databank and National
                                                                                           organisations




                                                                                  National Databank and National
                                                                                           organisations




                                               The Mastectomies (85.4) are a
                                                                                  National Databank and National
                                              subset of the Removal of breast
                                                                                           organisations
                                                    tumour procedures.




                                              The Simple mastectomies are a       National Databank and National
                                             subset of the Mastectomies (85.4)             organisations




                                             The Modified radical mastectomies
                                                                                  National Databank and National
                                              are a subset of the Mastectomies
                                                                                           organisations
                                                            (85.4)




                                              The Radical mastectomies are a         National Databank, National
                                             subset of the Mastectomies (85.4)   organisations and Expert Interviews




                                                                                  National Databank and National
                                                                                           organisations




                                                                                  National Databank and National
                                                                                           organisations
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                             Indication on Subgroups   SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                             Indication on Subgroups   SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                             Indication on Subgroups   SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                             Indication on Subgroups   SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes
 FORECAST:      FORECAST:      FORECAST:
Germany 2007   Germany 2008   Germany 2009
                                             Indication on Subgroups   SOURCES/ASSUMPTIONS
  Procedure      Procedure      Procedure
   Volumes        Volumes        Volumes
                                                                                                                         % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                            Improved Technique/




                                                                                                                                                                                                                                                Usage of technique
                                                                                                                                                                                                        Greying population
                                                                                                                                                                                                        Population growth/




                                                                                                                                                                                                                                                Lower acceptance/
                                                                                                                                                                                                                             Higher Awareness
                                                                                                                                                                                  Higher Incidence/




                                                                                                                                                                                                                                                                     Lower Incidence
                                                                              Italy 2004   Italy 2005   Italy 2006




                                                                                                                                                                Technology
     SURGICAL                                                      CODING                                                                  (See Methods
ID                    CATEGORY                PROCEDURE                       Procedure    Procedure    Procedure




                                                                                                                                                                                      Demand
     SPECIALTY                                                   (ICD-9-CM)                                                                   Tab for
                                                                               Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                                           Description of
                                                                                                                                             Process)




                 Operations on thyroid    Unilateral thyroid
1    GENERAL                                                        06.2
                 and parathyroid glands   lobectomy




                 Operations on thyroid    Complete
2    GENERAL                                                        06.4
                 and parathyroid glands   thyroidectomy




                 Operations on thyroid
3    GENERAL                              Parathyroidectomy         06.8
                 and parathyroid glands




                 Operations on other
4    GENERAL                              Total adrenalectomy       07.3
                 endocrine glands




                 Operations on other
5    GENERAL                              Hypophysectomy            07.6
                 endocrine glands




                 Operations on lymphatic Incision of lymphatic
6    GENERAL                                                        40.0
                 system                  structures




                 Operations on lymphatic Biopsy of lymphatic
7    GENERAL                                                       40.11
                 system                  structure
                                                                                                                              % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                                 Improved Technique/




                                                                                                                                                                                                                                                     Usage of technique
                                                                                                                                                                                                             Greying population
                                                                                                                                                                                                             Population growth/




                                                                                                                                                                                                                                                     Lower acceptance/
                                                                                                                                                                                                                                  Higher Awareness
                                                                                                                                                                                       Higher Incidence/




                                                                                                                                                                                                                                                                          Lower Incidence
                                                                                   Italy 2004   Italy 2005   Italy 2006




                                                                                                                                                                     Technology
     SURGICAL                                                        CODING                                                                     (See Methods
ID                     CATEGORY                 PROCEDURE                          Procedure    Procedure    Procedure




                                                                                                                                                                                           Demand
     SPECIALTY                                                     (ICD-9-CM)                                                                      Tab for
                                                                                    Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                Description of
                                                                                                                                                  Process)




                 Operations on lymphatic                            40.2 40.3
8    GENERAL                             Lymphadenectomy
                 system                                             40.4 40.5




                                            Bone marrow or
                 Operations on bone
9    GENERAL                                hematopoietic stem         41.0
                 marrow and spleen
                                            cell transplant




                 Operations on bone
10   GENERAL                                Splenectomy             41.43 41.5
                 marrow and spleen




                 Operations on
11   GENERAL                                Esophagectomy              42.4
                 esophagus




                 Operations on
12   GENERAL                                Esophagomyotomy            42.7
                 esophagus




                 Incision and excision of
13   GENERAL                                Gastrotomy                 43.0
                 stomach




                 Incision and excision of
14   GENERAL                                Pyloromyotomy              43.3
                 stomach




                                            Open extirpation of
15   GENERAL     Bariatric surgery
                                            lesion of stomach




                 Incision and excision of                         43.5 43.6 43.7
16   GENERAL                                Gastrectomy
                 stomach                                            43.8 43.9
                                                                                                                                        % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                                           Improved Technique/




                                                                                                                                                                                                                                                               Usage of technique
                                                                                                                                                                                                                       Greying population
                                                                                                                                                                                                                       Population growth/




                                                                                                                                                                                                                                                               Lower acceptance/
                                                                                                                                                                                                                                            Higher Awareness
                                                                                                                                                                                                 Higher Incidence/




                                                                                                                                                                                                                                                                                    Lower Incidence
                                                                                    Italy 2004      Italy 2005      Italy 2006




                                                                                                                                                                               Technology
     SURGICAL                                                         CODING                                                                              (See Methods
ID                     CATEGORY                 PROCEDURE                           Procedure       Procedure       Procedure




                                                                                                                                                                                                     Demand
     SPECIALTY                                                      (ICD-9-CM)                                                                               Tab for
                                                                                     Volumes         Volumes         Volumes        % Change '06 vs '05
                                                                                                                                                          Description of
                                                                                                                                                            Process)




                 Incision and excision of
17   GENERAL                                Vagotomy                    44.0
                 stomach




                                            Gastroenterostomy
                 Incision and excision of
18   GENERAL                                without gastrectomy         44.3
                 stomach
                                            (gastric bypass)




                                            Gastric Bypass,
19   GENERAL     Bariatric surgery                                                  Not available
                                            laparoscopic




20   GENERAL     Bariatric surgery          Gastric Bypass, open                    Not available




                 Operations on
21   GENERAL                                Fundoplication          Part of 44.66
                 esophagus




22   GENERAL     Bariatric surgery          Gastroplasty            44.68 44.69




                                            (Laparoscopic)
                                            adjustment of size of
23   GENERAL     Bariatric Surgery                                     44.98        Not available   Not available   Not available
                                            adjustable gastric
                                            restrictive device



                 Incision, excision, and
24   GENERAL                              Enterotomy                    45.0
                 anastomosis of intestine




                 Incision, excision, and  Excision of small
25   GENERAL                                                         45.3, 45.63
                 anastomosis of intestine intestine
                                                                                                                                    % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                                       Improved Technique/




                                                                                                                                                                                                                                                           Usage of technique
                                                                                                                                                                                                                   Greying population
                                                                                                                                                                                                                   Population growth/




                                                                                                                                                                                                                                                           Lower acceptance/
                                                                                                                                                                                                                                        Higher Awareness
                                                                                                                                                                                             Higher Incidence/




                                                                                                                                                                                                                                                                                Lower Incidence
                                                                                      Italy 2004      Italy 2005   Italy 2006




                                                                                                                                                                           Technology
     SURGICAL                                                          CODING                                                                         (See Methods
ID                    CATEGORY                 PROCEDURE                              Procedure       Procedure    Procedure




                                                                                                                                                                                                 Demand
     SPECIALTY                                                       (ICD-9-CM)                                                                          Tab for
                                                                                       Volumes         Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                      Description of
                                                                                                                                                        Process)




                 Incision, excision, and
26   GENERAL                              Small bowel resection   45.61 45.62 45.51
                 anastomosis of intestine




                 Incision, excision, and  Excision of large
27   GENERAL                                                         45.7 45.8
                 anastomosis of intestine intestine




                 Other operations on
28   GENERAL                              Right hemicolectomy          45.73
                 intestine




                 Other operations on
29   GENERAL                              Transverse colectomy         45.74
                 intestine




                 Other operations on
30   GENERAL                              Left hemicolectomy           45.75
                 intestine




31   GENERAL     Colorectal surgery       Hartmann procedure




                 Operations on rectum,
32   GENERAL     rectosigmoid and         Sigmoidectomy                45.76
                 perirectal tissue




                                          Other colectomies
33   GENERAL     Colorectal surgery                                    45.79
                                          (incl. subtotal)




34   GENERAL     Colorectal surgery       Total colectomy                             Not available
                                                                                                                                  % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                                     Improved Technique/




                                                                                                                                                                                                                                                         Usage of technique
                                                                                                                                                                                                                 Greying population
                                                                                                                                                                                                                 Population growth/




                                                                                                                                                                                                                                                         Lower acceptance/
                                                                                                                                                                                                                                      Higher Awareness
                                                                                                                                                                                           Higher Incidence/




                                                                                                                                                                                                                                                                              Lower Incidence
                                                                                    Italy 2004      Italy 2005   Italy 2006




                                                                                                                                                                         Technology
     SURGICAL                                                         CODING                                                                        (See Methods
ID                    CATEGORY                PROCEDURE                             Procedure       Procedure    Procedure




                                                                                                                                                                                               Demand
     SPECIALTY                                                      (ICD-9-CM)                                                                         Tab for
                                                                                     Volumes         Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                    Description of
                                                                                                                                                      Process)




35   GENERAL     Colorectal surgery       Total proctocolectomy                     Not available




                 Incision, excision, and
36   GENERAL                              Intestinal anastomosis        45.9
                 anastomosis of intestine




37   GENERAL     Colorectal surgery       J-Pouch procedure         Part of 45.95




                 Other operations on
38   GENERAL                              Colostomy                     46.1
                 intestine




                 Other operations on
39   GENERAL                              Ileostomy                     46.2
                 intestine




40   GENERAL     Operations on appendix Appendectomy                    47.0




                                          Drainage of
41   GENERAL     Operations on appendix                                 47.2
                                          appendiceal abscess




                 Operations on rectum,
                                          Proctotomy, with and
42   GENERAL     rectosigmoid and                                       48.0
                                          without anterior repair
                 perirectal tissue




                                          Excision of rectal
43   GENERAL     Colorectal surgery                                    48.35
                                          adenoma
                                                                                                                                    % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                                       Improved Technique/




                                                                                                                                                                                                                                                           Usage of technique
                                                                                                                                                                                                                   Greying population
                                                                                                                                                                                                                   Population growth/




                                                                                                                                                                                                                                                           Lower acceptance/
                                                                                                                                                                                                                                        Higher Awareness
                                                                                                                                                                                             Higher Incidence/




                                                                                                                                                                                                                                                                                Lower Incidence
                                                                                      Italy 2004      Italy 2005   Italy 2006




                                                                                                                                                                           Technology
     SURGICAL                                                           CODING                                                                        (See Methods
ID                    CATEGORY               PROCEDURE                                Procedure       Procedure    Procedure




                                                                                                                                                                                                 Demand
     SPECIALTY                                                        (ICD-9-CM)                                                                         Tab for
                                                                                       Volumes         Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                      Description of
                                                                                                                                                        Process)




                                         Reduction of rectal
44   GENERAL     Colorectal surgery
                                         mucosa




                 Operations on rectum,
                                         Abdomino-perineal
45   GENERAL     rectosigmoid and                                         48.5
                                         resection of anus
                 perirectal tissue




46   GENERAL     Colorectal surgery      Low anterior resection       Part of 48.63




47   GENERAL     Colorectal surgery      Rectopexy                    48.76 48.75




                                         Procedures on
48   GENERAL     Operations on anus                                       49.4        Not available
                                         Hemorrhoids




                                         Destruction of
49   GENERAL     Operations on anus                                   49.43, 49.44
                                         Hemorrhoids




50   GENERAL     Operations on anus      Hemorrhoidectomy                49.46




                                         Implantation of artificial
51   GENERAL     Colorectal surgery                                                   Not available
                                         anal sphincter




                                         Division of anal
52   GENERAL     Operations on anus                                       49.5
                                         sphincter
                                                                                                                             % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                                Improved Technique/




                                                                                                                                                                                                                                                    Usage of technique
                                                                                                                                                                                                            Greying population
                                                                                                                                                                                                            Population growth/




                                                                                                                                                                                                                                                    Lower acceptance/
                                                                                                                                                                                                                                 Higher Awareness
                                                                                                                                                                                      Higher Incidence/




                                                                                                                                                                                                                                                                         Lower Incidence
                                                                                  Italy 2004   Italy 2005   Italy 2006




                                                                                                                                                                    Technology
     SURGICAL                                                         CODING                                                                   (See Methods
ID                     CATEGORY                PROCEDURE                          Procedure    Procedure    Procedure




                                                                                                                                                                                          Demand
     SPECIALTY                                                      (ICD-9-CM)                                                                    Tab for
                                                                                   Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                                               Description of
                                                                                                                                                 Process)




53   GENERAL     Operations on anus        Repair of anus              49.7




                                           Other repair of anal
54   GENERAL     Colorectal surgery                                    49.79
                                           sphincter




55   GENERAL     Operations on liver       Hepatotomy                  50.0




                                           Hepatectomy (partial +
56   GENERAL     Operations on liver                                50.22 50.4
                                           complete)




57   GENERAL     Operations on liver       Lobectomy of liver          50.3




58   GENERAL     Operations on liver       Liver transplant            50.5




                 Operations on
59   GENERAL     gallbladder and biliary   Cholecystectomy             51.2
                 tract




                 Operations on
60   GENERAL     gallbladder and biliary   Open cholecystectomy     51.21 51.22
                 tract




                 Operations on
                                           Laparoscopic
61   GENERAL     gallbladder and biliary                            51.23 51.24
                                           cholecystectomy
                 tract
                                                                                                                                 % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                                    Improved Technique/




                                                                                                                                                                                                                                                        Usage of technique
                                                                                                                                                                                                                Greying population
                                                                                                                                                                                                                Population growth/




                                                                                                                                                                                                                                                        Lower acceptance/
                                                                                                                                                                                                                                     Higher Awareness
                                                                                                                                                                                          Higher Incidence/




                                                                                                                                                                                                                                                                             Lower Incidence
                                                                                   Italy 2004      Italy 2005   Italy 2006




                                                                                                                                                                        Technology
     SURGICAL                                                           CODING                                                                     (See Methods
ID                     CATEGORY                PROCEDURE                           Procedure       Procedure    Procedure




                                                                                                                                                                                              Demand
     SPECIALTY                                                        (ICD-9-CM)                                                                      Tab for
                                                                                    Volumes         Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                   Description of
                                                                                                                                                     Process)




                 Operations on
                                           Anastomosis of
62   GENERAL     gallbladder and biliary                                 51.3
                                           gallbladder or bile duct
                 tract



                 Operations on
                                           Pancreatectomy -
63   GENERAL     gallbladder and biliary                                52.52
                                           distal
                 tract




                                           Repair of inguinal
64   GENERAL     Repair of hernia                                     53.0 53.1
                                           hernia




                                           Inguinal herniorrhaphy,
65   GENERAL     Repair of hernia                                                  Not available
                                           laparoscopic




                                           Inguinal herniorrhaphy,
66   GENERAL     Repair of hernia                                                  Not available
                                           open




                                           Repair of femoral
67   GENERAL     Repair of hernia                                     53.2 53.3
                                           hernia




                                           Repair of recurrent
68   GENERAL     Repair of hernia          inguinal or femoral                     Not available
                                           hernia




                                           Repair of umbilical
69   GENERAL     Repair of hernia                                        53.4
                                           hernia




                                           Repair of incisional
70   GENERAL     Repair of hernia                                       53.51
                                           hernia
                                                                                                                                   % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                                      Improved Technique/




                                                                                                                                                                                                                                                          Usage of technique
                                                                                                                                                                                                                  Greying population
                                                                                                                                                                                                                  Population growth/




                                                                                                                                                                                                                                                          Lower acceptance/
                                                                                                                                                                                                                                       Higher Awareness
                                                                                                                                                                                            Higher Incidence/




                                                                                                                                                                                                                                                                               Lower Incidence
                                                                                     Italy 2004      Italy 2005   Italy 2006




                                                                                                                                                                          Technology
     SURGICAL                                                          CODING                                                                        (See Methods
ID                    CATEGORY                  PROCEDURE                            Procedure       Procedure    Procedure




                                                                                                                                                                                                Demand
     SPECIALTY                                                       (ICD-9-CM)                                                                         Tab for
                                                                                      Volumes         Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                     Description of
                                                                                                                                                       Process)




                 Other operations on
71   GENERAL                                Exploratory laparotomy      54.11
                 abdominal region




                 Other operations on        Lysis of peritoneal
72   GENERAL                                                             54.5
                 abdominal region           adhesions




                 Operations on rectum,
                                            Repair of Cystocele
73   GENERAL     rectosigmoid and                                       70.50
                                            and Rectocele
                 perirectal tissue




                 Operations on rectum,
74   GENERAL     rectosigmoid and           Cystocele repair            70.51
                 perirectal tissue




                 Operations on rectum,
75   GENERAL     rectosigmoid and           Rectocele repair            70.52
                 perirectal tissue




                 Operations on rectum,
                                            Obliteration of the
76   GENERAL     rectosigmoid and                                        70.8        Not available
                                            vaginal vault
                 perirectal tissue



                 Operations on rectum,
77   GENERAL     rectosigmoid and           Enterocele repair        Part of 70.92
                 perirectal tissue




78   GENERAL     Operations on the breast Breast biopsy, needle         85.11




79   GENERAL     Operations on the breast Breast biopsy, open           85.12




                                            Removal breast
80   GENERAL     Operations on the breast                                            Not available
                                            tumour
                                                                                                                                             % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                                                                Improved Technique/




                                                                                                                                                                                                                                                                    Usage of technique
                                                                                                                                                                                                                            Greying population
                                                                                                                                                                                                                            Population growth/




                                                                                                                                                                                                                                                                    Lower acceptance/
                                                                                                                                                                                                                                                 Higher Awareness
                                                                                                                                                                                                      Higher Incidence/




                                                                                                                                                                                                                                                                                         Lower Incidence
                                                                                         Italy 2004      Italy 2005      Italy 2006




                                                                                                                                                                                    Technology
     SURGICAL                                                            CODING                                                                                (See Methods
ID                     CATEGORY                 PROCEDURE                                Procedure       Procedure       Procedure




                                                                                                                                                                                                          Demand
     SPECIALTY                                                         (ICD-9-CM)                                                                                 Tab for
                                                                                          Volumes         Volumes         Volumes        % Change '06 vs '05
                                                                                                                                                               Description of
                                                                                                                                                                 Process)




                                            Removal lesion of
81   GENERAL     Operations on the breast                                 85.21
                                            breast - lumpectomy




                                            Subcutaneous               85.33, 85.34
82   GENERAL     Operations on the breast
                                            mastectomy                 85.35, 85.36




83   GENERAL     Operations on the breast Mastectomy                      85.4




                                            Simple mastectomy       85.41 85.42 + part
84   GENERAL     Operations on the breast
                                            (total mastectomy)       of 85.43 & 85.44




                                            Modified radical              Part of
85   GENERAL     Operations on the breast
                                            mastectomy                85.43 & 85.44




                                                                       85.45 85.46
86   GENERAL     Operations on the breast Radical mastectomy
                                                                       85.47 85.48




                                            Operations on duct of
87   GENERAL     Operations on the breast                                                Not available   Not available   Not available
                                            breast




88   GENERAL     Bariatric surgery          Abdominoplasty            Part of 86.83




                 Operations on rectum,
89   GENERAL     rectosigmoid and           Sacro-colpo-fixation
                 perirectal tissue
                                                                                                % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                   Improved Technique/




                                                                                                                                                                                                                       Usage of technique
                                                                                                                                                                               Greying population
                                                                                                                                                                               Population growth/




                                                                                                                                                                                                                       Lower acceptance/
                                                                                                                                                                                                    Higher Awareness
                                                                                                                                                         Higher Incidence/




                                                                                                                                                                                                                                            Lower Incidence
                                                     Italy 2004   Italy 2005   Italy 2006




                                                                                                                                       Technology
     SURGICAL                             CODING                                                                  (See Methods
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                             Demand
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                   Improved Technique/




                                                                                                                                                                                                                       Usage of technique
                                                                                                                                                                               Greying population
                                                                                                                                                                               Population growth/




                                                                                                                                                                                                                       Lower acceptance/
                                                                                                                                                                                                    Higher Awareness
                                                                                                                                                         Higher Incidence/




                                                                                                                                                                                                                                            Lower Incidence
                                                     Italy 2004   Italy 2005   Italy 2006




                                                                                                                                       Technology
     SURGICAL                             CODING                                                                  (See Methods
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                             Demand
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                   Improved Technique/




                                                                                                                                                                                                                       Usage of technique
                                                                                                                                                                               Greying population
                                                                                                                                                                               Population growth/




                                                                                                                                                                                                                       Lower acceptance/
                                                                                                                                                                                                    Higher Awareness
                                                                                                                                                         Higher Incidence/




                                                                                                                                                                                                                                            Lower Incidence
                                                     Italy 2004   Italy 2005   Italy 2006




                                                                                                                                       Technology
     SURGICAL                             CODING                                                                  (See Methods
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                             Demand
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                   Improved Technique/




                                                                                                                                                                                                                       Usage of technique
                                                                                                                                                                               Greying population
                                                                                                                                                                               Population growth/




                                                                                                                                                                                                                       Lower acceptance/
                                                                                                                                                                                                    Higher Awareness
                                                                                                                                                         Higher Incidence/




                                                                                                                                                                                                                                            Lower Incidence
                                                     Italy 2004   Italy 2005   Italy 2006




                                                                                                                                       Technology
     SURGICAL                             CODING                                                                  (See Methods
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                             Demand
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                   Improved Technique/




                                                                                                                                                                                                                       Usage of technique
                                                                                                                                                                               Greying population
                                                                                                                                                                               Population growth/




                                                                                                                                                                                                                       Lower acceptance/
                                                                                                                                                                                                    Higher Awareness
                                                                                                                                                         Higher Incidence/




                                                                                                                                                                                                                                            Lower Incidence
                                                     Italy 2004   Italy 2005   Italy 2006




                                                                                                                                       Technology
     SURGICAL                             CODING                                                                  (See Methods
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                             Demand
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                                  Confirmed Trend                                                                  Other




                                                                                                                                   Improved Technique/




                                                                                                                                                                                                                       Usage of technique
                                                                                                                                                                               Greying population
                                                                                                                                                                               Population growth/




                                                                                                                                                                                                                       Lower acceptance/
                                                                                                                                                                                                    Higher Awareness
                                                                                                                                                         Higher Incidence/




                                                                                                                                                                                                                                            Lower Incidence
                                                     Italy 2004   Italy 2005   Italy 2006




                                                                                                                                       Technology
     SURGICAL                             CODING                                                                  (See Methods
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                             Demand
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure      Indication on Subgroups     SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                                            National Databank and Opinion
                                                                                       Leaders




                                                                            National Databank and National
                                                                                     organisations




                                                                            National Databank and Opinion
                                                                                       Leaders




                                                                            National Databank and Opinion
                                                                                       Leaders




                                                                            National Databank and National
                                                                                     organisations




                                                                            National Databank and National
                                                                                     organisations




                                                                            National Databank and National
                                                                                     organisations
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure      Indication on Subgroups       SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                                             National Databank and National
                                                                                      organisations




                                                                               National Databank, National
                                                                            organisations and Expert Interviews




                                                                             National Databank and National
                                                                                      organisations




                                                                             National Databank and National
                                                                                      organisations




                                                                              National Databank and Opinion
                                                                                         Leaders




                                                                             National Databank and National
                                                                                      organisations




                                                                              National Databank and Opinion
                                                                                         Leaders




                                                                             National Databank and National
                                                                                      organisations




                                                                              National Databank and Opinion
                                                                                         Leaders
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure         Indication on Subgroups           SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                                                     National Databank and Opinion
                                                                                                Leaders




                                                                                     National Databank and National
                                                                                              organisations




                                                  The Laparoscopic Gastric Bypass
                                                   procedures are a subset of the   National Organisation and Opinion
                                                     Gastroenterostomy without                  Leaders
                                                   gastrectomy procedures (44.3)




                                                  The Laparoscopic Gastric Bypass
                                                   procedures are a subset of the   National Organisation and Opinion
                                                     Gastroenterostomy without                  Leaders
                                                   gastrectomy procedures (44.3)




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and Opinion
                                                                                                Leaders




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and National
                                                                                              organisations




                                                                                     National Databank and Opinion
                                                                                                Leaders
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure           Indication on Subgroups                SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                                                            National Databank and Opinion
                                                                                                       Leaders




                                                                                            National Databank and National
                                                                                                     organisations




                                                   The Right hemicolectomies (45.73)
                                                                                            National Databank and National
                                                  are a subset of the Excisions of large
                                                                                                     organisations
                                                          Intestine (45.7 45.8)




                                                  The Transverse colectomies (45.74)
                                                                                            National Databank and National
                                                  are a subset of the Excisions of large
                                                                                                     organisations
                                                          Intestine (45.7 45.8)




                                                  The Left hemicolectomies (45.75) are
                                                                                            National Databank and National
                                                    a subset of the Excisions of large
                                                                                                     organisations
                                                           Intestine (45.7 45.8)




                                                                                           National Organisation and Opinion
                                                                                                       Leaders




                                                   The Sigmoidectomies (45.76) are a
                                                                                            National Databank and National
                                                     subset of the Excisions of large
                                                                                                     organisations
                                                          Intestine (45.7 45.8)




                                                  The Other colectomies (45.79) are a
                                                                                            National Databank and Opinion
                                                    subset of the Excisions of large
                                                                                                       Leaders
                                                         Intestine (45.7 45.8)




                                                                                            National Databank and Opinion
                                                                                                       Leaders
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure           Indication on Subgroups              SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                                                        National Organisation and Opinion
                                                                                                    Leaders




                                                                                           National Databank, National
                                                                                        organisations and Expert Interviews




                                                  The J-Pouch procedures are a subset
                                                                                         National Databank and National
                                                      of the Intestinal Anastomosis
                                                                                                  organisations
                                                            procedures (45.9)




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                          National Databank and Opinion
                                                                                                     Leaders




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                          National Databank and Opinion
                                                                                                     Leaders




                                                                                          National Databank and Opinion
                                                                                                     Leaders




                                                                                         National Databank and National
                                                                                                  organisations
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure           Indication on Subgroups             SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                         National Databank and Opinion
                                                                                                    Leaders




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                         National Databank and Opinion
                                                                                                    Leaders




                                                    The Destruction of hemorrhoids
                                                    procedures (49.43, 49.44) are a      National Databank and Opinion
                                                   subset of the Total Procedures on                Leaders
                                                          hemorrhoids (49.4)




                                                  he Hemorrhoidectomies (49.46) are a
                                                                                         National Databank and National
                                                    subset of the Total procedures on
                                                                                                  organisations
                                                           hemorrhoids (49.4).




                                                                                        National Organisation and Opinion
                                                                                                    Leaders




                                                                                         National Databank and Opinion
                                                                                                    Leaders
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure            Indication on Subgroups                SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                                                            National Databank and National
                                                                                                     organisations




                                                    The Other repair of anal sphincter
                                                                                             National Databank and Opinion
                                                  Procedures (49.79) are a subset of the
                                                                                                        Leaders
                                                    Repair of Anus Procedures (49.7)




                                                                                             National Databank and Opinion
                                                                                                        Leaders




                                                                                            National Databank and National
                                                                                                     organisations




                                                                                              National Databank, National
                                                                                           organisations and Expert Interviews




                                                                                             National Databank and Opinion
                                                                                                        Leaders




                                                                                            National Databank and National
                                                                                                     organisations




                                                       The Open Cholecystectomy
                                                                                            National Databank and National
                                                  Procedures (51.21 51.22) are a subset
                                                                                                     organisations
                                                     of all Cholecystectomies (51.2)




                                                  The Laparoscopic cholecystectomies
                                                                                            National Databank and National
                                                    (51.23 51.24) are a subset of all
                                                                                                     organisations
                                                       Cholecystectomies (51.2)
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure           Indication on Subgroups               SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                            National Databank, National
                                                                                         organisations and Expert Interviews




                                                                                          National Databank and National
                                                                                                   organisations




                                                      The Laparoscopic Inguinal
                                                    Herniorrhaphy Procedures are a       National Organisation and Opinion
                                                   subset of Repair of inguinal hernia               Leaders
                                                              (53.0, 53.1).




                                                   The Open Inguinal Herniorrhaphy
                                                                                         National Organisation and Opinion
                                                  Procedures are a subset of Repair of
                                                                                                     Leaders
                                                      inguinal hernia (53.0, 53.1).




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                         National Organisation and Opinion
                                                                                                     Leaders




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                          National Databank and National
                                                                                                   organisations
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure           Indication on Subgroups                SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                                                            National Databank and Opinion
                                                                                                       Leaders




                                                                                             National Databank, National
                                                                                          organisations and Expert Interviews




                                                    The Cystocele/rectocele repairs
                                                                                             National Databank, National
                                                  (70.50) are a subset of the Repair of
                                                                                          organisations and Expert Interviews
                                                          prolapse procedures




                                                  The Cystocele repairs (70.51) are a
                                                                                            National Databank and Opinion
                                                   subset of the Repair of prolapse
                                                                                                       Leaders
                                                              procedures




                                                  The Rectocele repairs (70.52) are a
                                                                                           National Databank and National
                                                   subset of the Repair of prolapse
                                                                                                    organisations
                                                              procedures




                                                                                           National Databank and National
                                                                                                    organisations




                                                                                           National Databank and National
                                                                                                    organisations




                                                                                           National Databank and National
                                                                                                    organisations




                                                                                            National Databank and Opinion
                                                                                                       Leaders




                                                                                          National Organisation and Opinion
                                                                                                      Leaders
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure           Indication on Subgroups               SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes




                                                    The Lumpectomies (85.21) are a
                                                                                          National Databank and National
                                                    subset of the Removal of breast
                                                                                                   organisations
                                                          tumour procedures.




                                                                                          National Databank and National
                                                                                                   organisations




                                                  The Mastectomies (85.4) are a subset
                                                                                          National Databank and National
                                                    of the Removal of breast tumour
                                                                                                   organisations
                                                              procedures.




                                                    The Simple mastectomies are a         National Databank and National
                                                   subset of the Mastectomies (85.4)               organisations




                                                   The Modified radical mastectomies
                                                                                          National Databank and National
                                                    are a subset of the Mastectomies
                                                                                                   organisations
                                                                 (85.4)




                                                    The Radical mastectomies are a          National Databank, National
                                                   subset of the Mastectomies (85.4)     organisations and Expert Interviews




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                           National Databank and Opinion
                                                                                                      Leaders




                                                                                         National Organisation and Opinion
                                                                                                     Leaders
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure      Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure      Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure      Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure      Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure      Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes
FORECAST: Italy FORECAST: Italy FORECAST: Italy
2007 Procedure 2008 Procedure 2009 Procedure      Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes         Volumes         Volumes
                                                                                                                                    % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                            Higher Awareness
                                                                                                                                                                                    Higher Incidence/




                                                                                                                                                                                                                                                             Lower incidence
                                                                                                                                                                                                          growth/ Greying
                                                                                Spain 2004      Spain 2005      Spain 2006




                                                                                                                                                                                                                                               acceptance/
                                                                                                                                                                       Technology
     SURGICAL                                                        CODING




                                                                                                                                                                       Technique/




                                                                                                                                                                                                            Population
                                                                                                                                                                                                             population
                                                                                                                                                      (See Methods




                                                                                                                                                                                                                                                technique
                                                                                                                                                                        Improved




                                                                                                                                                                                                                                                 Usage of
ID                     CATEGORY                PROCEDURE                        Procedure       Procedure       Procedure




                                                                                                                                                                                        demand




                                                                                                                                                                                                                                                  Lower
     SPECIALTY                                                     (ICD-9-CM)                                                                            Tab for
                                                                                 Volumes         Volumes         Volumes        % Change '06 vs '05
                                                                                                                                                      Description of
                                                                                                                                                        Process)




                 Operations on thyroid     Unilateral thyroid
1    GENERAL                                                          06.2
                 and parathyroid glands    lobectomy




                 Operations on thyroid     Complete
2    GENERAL                                                          06.4
                 and parathyroid glands    thyroidectomy




                 Operations on thyroid
3    GENERAL                               Parathyroidectomy          06.8
                 and parathyroid glands




                 Operations on other
4    GENERAL                               Total adrenalectomy        07.3
                 endocrine glands




                 Operations on other
5    GENERAL                               Hypophysectomy             07.6
                 endocrine glands




                 Operations on lymphatic   Incision of lymphatic
6    GENERAL                                                          40.0
                 system                    structures




                 Operations on lymphatic   Biopsy of lymphatic
7    GENERAL                                                         40.11      Not available   Not available   Not available
                 system                    structure
                                                                                                                                  % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                          Higher Awareness
                                                                                                                                                                                  Higher Incidence/




                                                                                                                                                                                                                                                           Lower incidence
                                                                                                                                                                                                        growth/ Greying
                                                                                       Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                                                             acceptance/
                                                                                                                                                                     Technology
     SURGICAL                                                            CODING




                                                                                                                                                                     Technique/




                                                                                                                                                                                                          Population
                                                                                                                                                                                                           population
                                                                                                                                                    (See Methods




                                                                                                                                                                                                                                              technique
                                                                                                                                                                      Improved




                                                                                                                                                                                                                                               Usage of
ID                     CATEGORY                 PROCEDURE                              Procedure    Procedure    Procedure




                                                                                                                                                                                      demand




                                                                                                                                                                                                                                                Lower
     SPECIALTY                                                         (ICD-9-CM)                                                                      Tab for
                                                                                        Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                    Description of
                                                                                                                                                      Process)




                 Operations on lymphatic                                40.2 40.3
8    GENERAL                                Lymphadenectomy
                 system                                                 40.4 40.5




                                            Bone marrow or
                 Operations on bone
9    GENERAL                                hematopoietic stem cell        41.0
                 marrow and spleen
                                            transplant




                 Operations on bone
10   GENERAL                                Splenectomy                 41.43 41.5
                 marrow and spleen




                 Operations on
11   GENERAL                                Esophagectomy                  42.4
                 esophagus




                 Operations on
12   GENERAL                                Esophagomyotomy                42.7
                 esophagus




                 Incision and excision of
13   GENERAL                                Gastrotomy                     43.0
                 stomach




                 Incision and excision of
14   GENERAL                                Pyloromyotomy                  43.3
                 stomach




                                            Open extirpation of
15   GENERAL     Bariatric surgery
                                            lesion of stomach




                 Incision and excision of                             43.5 43.6 43.7
16   GENERAL                                Gastrectomy
                 stomach                                                 43.8 43.9
                                                                                                                                        % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                                Higher Awareness
                                                                                                                                                                                        Higher Incidence/




                                                                                                                                                                                                                                                                 Lower incidence
                                                                                                                                                                                                              growth/ Greying
                                                                                    Spain 2004      Spain 2005      Spain 2006




                                                                                                                                                                                                                                                   acceptance/
                                                                                                                                                                           Technology
     SURGICAL                                                         CODING




                                                                                                                                                                           Technique/




                                                                                                                                                                                                                Population
                                                                                                                                                                                                                 population
                                                                                                                                                          (See Methods




                                                                                                                                                                                                                                                    technique
                                                                                                                                                                            Improved




                                                                                                                                                                                                                                                     Usage of
ID                     CATEGORY                 PROCEDURE                           Procedure       Procedure       Procedure




                                                                                                                                                                                            demand




                                                                                                                                                                                                                                                      Lower
     SPECIALTY                                                      (ICD-9-CM)                                                                               Tab for
                                                                                     Volumes         Volumes         Volumes        % Change '06 vs '05
                                                                                                                                                          Description of
                                                                                                                                                            Process)




                 Incision and excision of
17   GENERAL                                Vagotomy                    44.0
                 stomach




                                            Gastroenterostomy
                 Incision and excision of
18   GENERAL                                without gastrectomy         44.3
                 stomach
                                            (gastric bypass)




                                            Gastric Bypass,
19   GENERAL     Bariatric surgery
                                            laparoscopic




20   GENERAL     Bariatric surgery          Gastric Bypass, open




                 Operations on
21   GENERAL                                Fundoplication          Part of 44.66
                 esophagus




22   GENERAL     Bariatric surgery          Gastroplasty            44.68 44.69




                                            (Laparoscopic)
                                            adjustment of size of
23   GENERAL     Bariatric Surgery                                     44.98        Not available   Not available   Not available
                                            adjustable gastric
                                            restrictive device



                 Incision, excision, and
24   GENERAL                                Enterotomy                  45.0
                 anastomosis of intestine




                 Incision, excision, and    Excision of small
25   GENERAL                                                         45.3, 45.63
                 anastomosis of intestine   intestine
                                                                                                                                      % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                              Higher Awareness
                                                                                                                                                                                      Higher Incidence/




                                                                                                                                                                                                                                                               Lower incidence
                                                                                                                                                                                                            growth/ Greying
                                                                                           Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                                                                 acceptance/
                                                                                                                                                                         Technology
     SURGICAL                                                               CODING




                                                                                                                                                                         Technique/




                                                                                                                                                                                                              Population
                                                                                                                                                                                                               population
                                                                                                                                                        (See Methods




                                                                                                                                                                                                                                                  technique
                                                                                                                                                                          Improved




                                                                                                                                                                                                                                                   Usage of
ID                     CATEGORY                 PROCEDURE                                  Procedure    Procedure    Procedure




                                                                                                                                                                                          demand




                                                                                                                                                                                                                                                    Lower
     SPECIALTY                                                            (ICD-9-CM)                                                                       Tab for
                                                                                            Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                        Description of
                                                                                                                                                          Process)




                 Incision, excision, and
26   GENERAL                                Small bowel resection      45.61 45.62 45.51
                 anastomosis of intestine




                 Incision, excision, and    Excision of large
27   GENERAL                                                              45.7 45.8
                 anastomosis of intestine   intestine




                 Other operations on
28   GENERAL                                Right hemicolectomy             45.73
                 intestine




                 Other operations on
29   GENERAL                                Transverse colectomy            45.74
                 intestine




                 Other operations on
30   GENERAL                                Left hemicolectomy              45.75
                 intestine




31   GENERAL     Colorectal surgery         Hartmann procedure




                 Operations on rectum,
32   GENERAL     rectosigmoid and           Sigmoidectomy                   45.76
                 perirectal tissue




                                            Other colectomies (incl.
33   GENERAL     Colorectal surgery                                         45.79
                                            subtotal)




34   GENERAL     Colorectal surgery         Total colectomy
                                                                                                                                 % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                         Higher Awareness
                                                                                                                                                                                 Higher Incidence/




                                                                                                                                                                                                                                                          Lower incidence
                                                                                                                                                                                                       growth/ Greying
                                                                                      Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                                                            acceptance/
                                                                                                                                                                    Technology
     SURGICAL                                                           CODING




                                                                                                                                                                    Technique/




                                                                                                                                                                                                         Population
                                                                                                                                                                                                          population
                                                                                                                                                   (See Methods




                                                                                                                                                                                                                                             technique
                                                                                                                                                                     Improved




                                                                                                                                                                                                                                              Usage of
ID                     CATEGORY                 PROCEDURE                             Procedure    Procedure    Procedure




                                                                                                                                                                                     demand




                                                                                                                                                                                                                                               Lower
     SPECIALTY                                                        (ICD-9-CM)                                                                      Tab for
                                                                                       Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                   Description of
                                                                                                                                                     Process)




35   GENERAL     Colorectal surgery         Total proctocolectomy




                 Incision, excision, and
36   GENERAL                                Intestinal anastomosis        45.9
                 anastomosis of intestine




37   GENERAL     Colorectal surgery         J-Pouch procedure         Part of 45.95




                 Other operations on
38   GENERAL                                Colostomy                     46.1
                 intestine




                 Other operations on
39   GENERAL                                Ileostomy                     46.2
                 intestine




40   GENERAL     Operations on appendix     Appendectomy                  47.0




                                            Drainage of
41   GENERAL     Operations on appendix                                   47.2
                                            appendiceal abscess




                 Operations on rectum,
                                            Proctotomy, with and
42   GENERAL     rectosigmoid and                                         48.0
                                            without anterior repair
                 perirectal tissue




                                            Excision of rectal
43   GENERAL     Colorectal surgery                                      48.35
                                            adenoma
                                                                                                                                 % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                         Higher Awareness
                                                                                                                                                                                 Higher Incidence/




                                                                                                                                                                                                                                                          Lower incidence
                                                                                                                                                                                                       growth/ Greying
                                                                                      Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                                                            acceptance/
                                                                                                                                                                    Technology
     SURGICAL                                                           CODING




                                                                                                                                                                    Technique/




                                                                                                                                                                                                         Population
                                                                                                                                                                                                          population
                                                                                                                                                   (See Methods




                                                                                                                                                                                                                                             technique
                                                                                                                                                                     Improved




                                                                                                                                                                                                                                              Usage of
ID                     CATEGORY              PROCEDURE                                Procedure    Procedure    Procedure




                                                                                                                                                                                     demand




                                                                                                                                                                                                                                               Lower
     SPECIALTY                                                        (ICD-9-CM)                                                                      Tab for
                                                                                       Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                   Description of
                                                                                                                                                     Process)




                                         Reduction of rectal
44   GENERAL     Colorectal surgery
                                         mucosa




                 Operations on rectum,
                                         Abdomino-perineal
45   GENERAL     rectosigmoid and                                         48.5
                                         resection of anus
                 perirectal tissue




46   GENERAL     Colorectal surgery      Low anterior resection       Part of 48.63




47   GENERAL     Colorectal surgery      Rectopexy                    48.76 48.75




                                         Procedures on
48   GENERAL     Operations on anus                                       49.4
                                         Hemorrhoids




                                         Destruction of
49   GENERAL     Operations on anus                                   49.43, 49.44
                                         Hemorrhoids




50   GENERAL     Operations on anus      Hemorrhoidectomy                49.46




                                         Implantation of artificial
51   GENERAL     Colorectal surgery
                                         anal sphincter




                                         Division of anal
52   GENERAL     Operations on anus                                       49.5
                                         sphincter
                                                                                                                             % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                     Higher Awareness
                                                                                                                                                                             Higher Incidence/




                                                                                                                                                                                                                                                      Lower incidence
                                                                                                                                                                                                   growth/ Greying
                                                                                  Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                                                        acceptance/
                                                                                                                                                                Technology
     SURGICAL                                                         CODING




                                                                                                                                                                Technique/




                                                                                                                                                                                                     Population
                                                                                                                                                                                                      population
                                                                                                                                               (See Methods




                                                                                                                                                                                                                                         technique
                                                                                                                                                                 Improved




                                                                                                                                                                                                                                          Usage of
ID                     CATEGORY                PROCEDURE                          Procedure    Procedure    Procedure




                                                                                                                                                                                 demand




                                                                                                                                                                                                                                           Lower
     SPECIALTY                                                      (ICD-9-CM)                                                                    Tab for
                                                                                   Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                                               Description of
                                                                                                                                                 Process)




53   GENERAL     Operations on anus        Repair of anus              49.7




                                           Other repair of anal
54   GENERAL     Colorectal surgery                                    49.79
                                           sphincter




55   GENERAL     Operations on liver       Hepatotomy                  50.0




                                           Hepatectomy (partial +
56   GENERAL     Operations on liver                                50.22 50.4
                                           complete)




57   GENERAL     Operations on liver       Lobectomy of liver          50.3




58   GENERAL     Operations on liver       Liver transplant            50.5




                 Operations on
59   GENERAL     gallbladder and biliary   Cholecystectomy             51.2
                 tract




                 Operations on
60   GENERAL     gallbladder and biliary   Open cholecystectomy     51.21 51.22
                 tract




                 Operations on
                                           Laparoscopic
61   GENERAL     gallbladder and biliary                            51.23 51.24
                                           cholecystectomy
                 tract
                                                                                                                              % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                      Higher Awareness
                                                                                                                                                                              Higher Incidence/




                                                                                                                                                                                                                                                       Lower incidence
                                                                                                                                                                                                    growth/ Greying
                                                                                   Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                                                         acceptance/
                                                                                                                                                                 Technology
     SURGICAL                                                           CODING




                                                                                                                                                                 Technique/




                                                                                                                                                                                                      Population
                                                                                                                                                                                                       population
                                                                                                                                                (See Methods




                                                                                                                                                                                                                                          technique
                                                                                                                                                                  Improved




                                                                                                                                                                                                                                           Usage of
ID                     CATEGORY                PROCEDURE                           Procedure    Procedure    Procedure




                                                                                                                                                                                  demand




                                                                                                                                                                                                                                            Lower
     SPECIALTY                                                        (ICD-9-CM)                                                                   Tab for
                                                                                    Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                Description of
                                                                                                                                                  Process)




                 Operations on
                                           Anastomosis of
62   GENERAL     gallbladder and biliary                                 51.3
                                           gallbladder or bile duct
                 tract



                 Operations on
63   GENERAL     gallbladder and biliary   Pancreatectomy - distal      52.52
                 tract




                                           Repair of inguinal
64   GENERAL     Repair of hernia                                     53.0 53.1
                                           hernia




                                           Inguinal herniorrhaphy,
65   GENERAL     Repair of hernia
                                           laparoscopic




                                           Inguinal herniorrhaphy,
66   GENERAL     Repair of hernia
                                           open




                                           Repair of femoral
67   GENERAL     Repair of hernia                                     53.2 53.3
                                           hernia




                                           Repair of recurrent
68   GENERAL     Repair of hernia          inguinal or femoral
                                           hernia




                                           Repair of umbilical
69   GENERAL     Repair of hernia                                        53.4
                                           hernia




                                           Repair of incisional
70   GENERAL     Repair of hernia                                       53.51
                                           hernia
                                                                                                                                 % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                         Higher Awareness
                                                                                                                                                                                 Higher Incidence/




                                                                                                                                                                                                                                                          Lower incidence
                                                                                                                                                                                                       growth/ Greying
                                                                                   Spain 2004      Spain 2005   Spain 2006




                                                                                                                                                                                                                                            acceptance/
                                                                                                                                                                    Technology
     SURGICAL                                                        CODING




                                                                                                                                                                    Technique/




                                                                                                                                                                                                         Population
                                                                                                                                                                                                          population
                                                                                                                                                   (See Methods




                                                                                                                                                                                                                                             technique
                                                                                                                                                                     Improved




                                                                                                                                                                                                                                              Usage of
ID                    CATEGORY                PROCEDURE                            Procedure       Procedure    Procedure




                                                                                                                                                                                     demand




                                                                                                                                                                                                                                               Lower
     SPECIALTY                                                     (ICD-9-CM)                                                                         Tab for
                                                                                    Volumes         Volumes      Volumes     % Change '06 vs '05
                                                                                                                                                   Description of
                                                                                                                                                     Process)




                 Other operations on
71   GENERAL                              Exploratory laparotomy      54.11
                 abdominal region




                 Other operations on      Lysis of peritoneal
72   GENERAL                                                           54.5
                 abdominal region         adhesions




                 Operations on rectum,
                                          Repair of Cystocele
73   GENERAL     rectosigmoid and                                     70.50
                                          and Rectocele
                 perirectal tissue




                 Operations on rectum,
74   GENERAL     rectosigmoid and         Cystocele repair            70.51
                 perirectal tissue




                 Operations on rectum,
75   GENERAL     rectosigmoid and         Rectocele repair            70.52
                 perirectal tissue




                 Operations on rectum,
                                          Obliteration of the
76   GENERAL     rectosigmoid and                                      70.8        Not available
                                          vaginal vault
                 perirectal tissue



                 Operations on rectum,
77   GENERAL     rectosigmoid and         Enterocele repair        Part of 70.92
                 perirectal tissue




78   GENERAL     Operations on the breast Breast biopsy, needle       85.11




79   GENERAL     Operations on the breast Breast biopsy, open         85.12




80   GENERAL     Operations on the breast Removal breast tumour                    Not available
                                                                                                                                             % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                                                                     Higher Awareness
                                                                                                                                                                                             Higher Incidence/




                                                                                                                                                                                                                                                                      Lower incidence
                                                                                                                                                                                                                   growth/ Greying
                                                                                         Spain 2004      Spain 2005      Spain 2006




                                                                                                                                                                                                                                                        acceptance/
                                                                                                                                                                                Technology
     SURGICAL                                                            CODING




                                                                                                                                                                                Technique/




                                                                                                                                                                                                                     Population
                                                                                                                                                                                                                      population
                                                                                                                                                               (See Methods




                                                                                                                                                                                                                                                         technique
                                                                                                                                                                                 Improved




                                                                                                                                                                                                                                                          Usage of
ID                     CATEGORY                 PROCEDURE                                Procedure       Procedure       Procedure




                                                                                                                                                                                                 demand




                                                                                                                                                                                                                                                           Lower
     SPECIALTY                                                         (ICD-9-CM)                                                                                 Tab for
                                                                                          Volumes         Volumes         Volumes        % Change '06 vs '05
                                                                                                                                                               Description of
                                                                                                                                                                 Process)




                                            Removal lesion of
81   GENERAL     Operations on the breast                                 85.21
                                            breast - lumpectomy




                                            Subcutaneous               85.33, 85.34
82   GENERAL     Operations on the breast
                                            mastectomy                 85.35, 85.36




83   GENERAL     Operations on the breast Mastectomy                      85.4




                                            Simple mastectomy       85.41 85.42 + part
84   GENERAL     Operations on the breast
                                            (total mastectomy)       of 85.43 & 85.44




                                            Modified radical             Part of
85   GENERAL     Operations on the breast
                                            mastectomy               85.43 & 85.44




                                                                       85.45 85.46
86   GENERAL     Operations on the breast Radical mastectomy
                                                                       85.47 85.48




                                            Operations on duct of
87   GENERAL     Operations on the breast                                                Not available   Not available   Not available
                                            breast




88   GENERAL     Bariatric surgery          Abdominoplasty            Part of 86.83




                 Operations on rectum,
89   GENERAL     rectosigmoid and           Sacro-colpo-fixation
                 perirectal tissue
                                                                                                % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                        Higher Awareness
                                                                                                                                                Higher Incidence/




                                                                                                                                                                                                                         Lower incidence
                                                                                                                                                                      growth/ Greying
                                                     Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                           acceptance/
                                                                                                                                   Technology
     SURGICAL                             CODING




                                                                                                                                   Technique/




                                                                                                                                                                        Population
                                                                                                                                                                         population
                                                                                                                  (See Methods




                                                                                                                                                                                                            technique
                                                                                                                                    Improved




                                                                                                                                                                                                             Usage of
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                    demand




                                                                                                                                                                                                              Lower
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                        Higher Awareness
                                                                                                                                                Higher Incidence/




                                                                                                                                                                                                                         Lower incidence
                                                                                                                                                                      growth/ Greying
                                                     Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                           acceptance/
                                                                                                                                   Technology
     SURGICAL                             CODING




                                                                                                                                   Technique/




                                                                                                                                                                        Population
                                                                                                                                                                         population
                                                                                                                  (See Methods




                                                                                                                                                                                                            technique
                                                                                                                                    Improved




                                                                                                                                                                                                             Usage of
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                    demand




                                                                                                                                                                                                              Lower
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                        Higher Awareness
                                                                                                                                                Higher Incidence/




                                                                                                                                                                                                                         Lower incidence
                                                                                                                                                                      growth/ Greying
                                                     Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                           acceptance/
                                                                                                                                   Technology
     SURGICAL                             CODING




                                                                                                                                   Technique/




                                                                                                                                                                        Population
                                                                                                                                                                         population
                                                                                                                  (See Methods




                                                                                                                                                                                                            technique
                                                                                                                                    Improved




                                                                                                                                                                                                             Usage of
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                    demand




                                                                                                                                                                                                              Lower
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                        Higher Awareness
                                                                                                                                                Higher Incidence/




                                                                                                                                                                                                                         Lower incidence
                                                                                                                                                                      growth/ Greying
                                                     Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                           acceptance/
                                                                                                                                   Technology
     SURGICAL                             CODING




                                                                                                                                   Technique/




                                                                                                                                                                        Population
                                                                                                                                                                         population
                                                                                                                  (See Methods




                                                                                                                                                                                                            technique
                                                                                                                                    Improved




                                                                                                                                                                                                             Usage of
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                    demand




                                                                                                                                                                                                              Lower
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                        Higher Awareness
                                                                                                                                                Higher Incidence/




                                                                                                                                                                                                                         Lower incidence
                                                                                                                                                                      growth/ Greying
                                                     Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                           acceptance/
                                                                                                                                   Technology
     SURGICAL                             CODING




                                                                                                                                   Technique/




                                                                                                                                                                        Population
                                                                                                                                                                         population
                                                                                                                  (See Methods




                                                                                                                                                                                                            technique
                                                                                                                                    Improved




                                                                                                                                                                                                             Usage of
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                    demand




                                                                                                                                                                                                              Lower
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
                                                                                                % Change            Process                                         Confirmed Trend                                                        Other




                                                                                                                                                                                        Higher Awareness
                                                                                                                                                Higher Incidence/




                                                                                                                                                                                                                         Lower incidence
                                                                                                                                                                      growth/ Greying
                                                     Spain 2004   Spain 2005   Spain 2006




                                                                                                                                                                                                           acceptance/
                                                                                                                                   Technology
     SURGICAL                             CODING




                                                                                                                                   Technique/




                                                                                                                                                                        Population
                                                                                                                                                                         population
                                                                                                                  (See Methods




                                                                                                                                                                                                            technique
                                                                                                                                    Improved




                                                                                                                                                                                                             Usage of
ID               CATEGORY   PROCEDURE                Procedure    Procedure    Procedure




                                                                                                                                                    demand




                                                                                                                                                                                                              Lower
     SPECIALTY                          (ICD-9-CM)                                                                   Tab for
                                                      Volumes      Volumes      Volumes     % Change '06 vs '05
                                                                                                                  Description of
                                                                                                                    Process)
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                 Indication on Subgroups   SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                 Indication on Subgroups   SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews




                                                                         National Databank and Expert
                                                                                   Interviews
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                    Indication on Subgroups        SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                                                                 National Databank and Expert
                                                                                           Interviews




                                                                                 National Databank and Expert
                                                                                           Interviews




                                               The Laparoscopic Gastric Bypass
                                                procedures are a subset of the   National Databank and Expert
                                                  Gastroenterostomy without                Interviews
                                                gastrectomy procedures (44.3)




                                               The Laparoscopic Gastric Bypass
                                                procedures are a subset of the   National Databank and Expert
                                                  Gastroenterostomy without                Interviews
                                                gastrectomy procedures (44.3)




                                                                                 National Databank and Expert
                                                                                           Interviews




                                                                                 National Databank and Expert
                                                                                           Interviews




                                                                                 National Databank and Expert
                                                                                           Interviews




                                                                                 National Databank and Expert
                                                                                           Interviews




                                                                                 National Databank and Expert
                                                                                           Interviews
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                     Indication on Subgroups           SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                               The Right hemicolectomies (45.73)
                                                                                     National Databank and Expert
                                                are a subset of the Excisions of
                                                                                               Interviews
                                                   large Intestine (45.7 45.8)




                                               The Transverse colectomies (45.74)
                                                                                     National Databank and Expert
                                                 are a subset of the Excisions of
                                                                                               Interviews
                                                    large Intestine (45.7 45.8)




                                                The Left hemicolectomies (45.75)
                                                                                     National Databank and Expert
                                                 are a subset of the Excisions of
                                                                                               Interviews
                                                    large Intestine (45.7 45.8)




                                                                                     National Databank and Expert
                                                                                               Interviews




                                               The Sigmoidectomies (45.76) are a
                                                                                     National Databank and Expert
                                                 subset of the Excisions of large
                                                                                               Interviews
                                                      Intestine (45.7 45.8)




                                               The Other colectomies (45.79) are a
                                                                                     National Databank and Expert
                                                 subset of the Excisions of large
                                                                                               Interviews
                                                      Intestine (45.7 45.8)




                                                                                     National Databank and Expert
                                                                                               Interviews
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                     Indication on Subgroups            SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                                                                      National Databank and Expert
                                                                                                Interviews




                                                                                      National Databank and Expert
                                                                                                Interviews




                                                 The J-Pouch procedures are a
                                                                                      National Databank and Expert
                                               subset of the Intestinal Anastomosis
                                                                                                Interviews
                                                        procedures (45.9)




                                                                                      National Databank and Expert
                                                                                                Interviews




                                                                                      National Databank and Expert
                                                                                                Interviews




                                                                                      National Databank and Expert
                                                                                                Interviews




                                                                                      National Databank and Expert
                                                                                                Interviews




                                                                                      National Databank and Expert
                                                                                                Interviews




                                                                                      National Databank and Expert
                                                                                                Interviews
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                     Indication on Subgroups           SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                The Destruction of hemorrhoids
                                                procedures (49.43, 49.44) are a      National Databank and Expert
                                               subset of the Total Procedures on               Interviews
                                                      hemorrhoids (49.4)




                                               he Hemorrhoidectomies (49.46) are
                                                                                     National Databank and Expert
                                               a subset of the Total procedures on
                                                                                               Interviews
                                                      hemorrhoids (49.4).




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                     Indication on Subgroups           SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                                                                     National Databank and Expert
                                                                                               Interviews




                                               The Other repair of anal sphincter
                                               Procedures (49.79) are a subset of    National Databank and Expert
                                                 the Repair of Anus Procedures                 Interviews
                                                             (49.7)




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                   The Open Cholecystectomy
                                                 Procedures (51.21 51.22) are a      National Databank and Expert
                                                 subset of all Cholecystectomies               Interviews
                                                               (51.2)




                                                        The Laparoscopic
                                               cholecystectomies (51.23 51.24) are   National Databank and Expert
                                                a subset of all Cholecystectomies              Interviews
                                                               (51.2)
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                    Indication on Subgroups            SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                  The Laparoscopic Inguinal
                                                Herniorrhaphy Procedures are a       National Databank and Expert
                                               subset of Repair of inguinal hernia             Interviews
                                                          (53.0, 53.1).




                                               The Open Inguinal Herniorrhaphy
                                                                                     National Databank and Expert
                                               Procedures are a subset of Repair
                                                                                               Interviews
                                                 of inguinal hernia (53.0, 53.1).




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews




                                                                                     National Databank and Expert
                                                                                               Interviews
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                      Indication on Subgroups            SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                                                                       National Databank and Expert
                                                                                                 Interviews




                                                                                       National Databank and Expert
                                                                                                 Interviews




                                                 The Cystocele/rectocele repairs
                                                                                       National Databank and Expert
                                               (70.50) are a subset of the Repair of
                                                                                                 Interviews
                                                       prolapse procedures




                                               The Cystocele repairs (70.51) are a
                                                                                       National Databank and Expert
                                                subset of the Repair of prolapse
                                                                                                 Interviews
                                                           procedures




                                               The Rectocele repairs (70.52) are a
                                                                                       National Databank and Expert
                                                subset of the Repair of prolapse
                                                                                                 Interviews
                                                           procedures




                                                                                       National Databank and Expert
                                                                                                 Interviews




                                                                                       National Databank and Expert
                                                                                                 Interviews




                                                                                       National Databank and Expert
                                                                                                 Interviews




                                                                                       National Databank and Expert
                                                                                                 Interviews




                                                                                       National Databank and Expert
                                                                                                 Interviews
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                     Indication on Subgroups         SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes




                                               The Lumpectomies (85.21) are a
                                                                                   National Databank and Expert
                                               subset of the Removal of breast
                                                                                             Interviews
                                                     tumour procedures.




                                                                                   National Databank and Expert
                                                                                             Interviews




                                                 The Mastectomies (85.4) are a
                                                                                   National Databank and Expert
                                                subset of the Removal of breast
                                                                                             Interviews
                                                      tumour procedures.




                                                The Simple mastectomies are a      National Databank and Expert
                                               subset of the Mastectomies (85.4)             Interviews




                                               The Modified radical mastectomies
                                                                                   National Databank and Expert
                                                are a subset of the Mastectomies
                                                                                             Interviews
                                                              (85.4)




                                                The Radical mastectomies are a     National Databank and Expert
                                               subset of the Mastectomies (85.4)             Interviews




                                                                                   National Databank and Expert
                                                                                             Interviews




                                                                                   National Databank and Expert
                                                                                             Interviews




                                                                                   National Databank and Expert
                                                                                             Interviews
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                 Indication on Subgroups   SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                 Indication on Subgroups   SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                 Indication on Subgroups   SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                 Indication on Subgroups   SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                 Indication on Subgroups   SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes
FORECAST:                        FORECAST:
              FORECAST:Spai
 Spain 2007                       Spain 2009
              n 2008 Procedure                 Indication on Subgroups   SOURCES/ASSUMPTIONS
 Procedure                        Procedure
                  Volumes
  Volumes                          Volumes
                                                                                                                         % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                            Improved Technique/




                                                                                                                                                                                                        Population growth/




                                                                                                                                                                                                                                                usage of technique
                                                                                                                                                                                                        greying population




                                                                                                                                                                                                                                                Lower acceptance/
                                                                                                                                                                                                                             Higher Awareness
                                                                                                                                                                                  Higher Incidence/




                                                                                                                                                                                                                                                                     Lower incidence/
                                                                                  UK 2004     UK 2005     UK 2006




                                                                                                                                                                Technology
     SURGICAL                                                         CODING                                                               (See Methods
ID                     CATEGORY                 PROCEDURE                        Procedure   Procedure   Procedure




                                                                                                                                                                                      demand




                                                                                                                                                                                                                                                                        demand
     SPECIALTY                                                      (ICD-9-CM)                                                                Tab for
                                                                                  Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                                                           Description of
                                                                                                                                             Process)




                 Operations on thyroid and Unilateral thyroid
1    GENERAL                                                           06.2
                 parathyroid glands        lobectomy




                 Operations on thyroid and Complete
2    GENERAL                                                           06.4
                 parathyroid glands        thyroidectomy




                 Operations on thyroid and
3    GENERAL                               Parathyroidectomy           06.8
                 parathyroid glands




                 Operations on other
4    GENERAL                                Total adrenalectomy        07.3
                 endocrine glands




                 Operations on other
5    GENERAL                                Hypophysectomy             07.6
                 endocrine glands




                 Operations on lymphatic    Incision of lymphatic
6    GENERAL                                                           40.0
                 system                     structures




                 Operations on lymphatic    Biopsy of lymphatic
7    GENERAL                                                          40.11
                 system                     structure
                                                                                                                           % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                              Improved Technique/




                                                                                                                                                                                                          Population growth/




                                                                                                                                                                                                                                                  usage of technique
                                                                                                                                                                                                          greying population




                                                                                                                                                                                                                                                  Lower acceptance/
                                                                                                                                                                                                                               Higher Awareness
                                                                                                                                                                                    Higher Incidence/




                                                                                                                                                                                                                                                                       Lower incidence/
                                                                                    UK 2004     UK 2005     UK 2006




                                                                                                                                                                  Technology
     SURGICAL                                                        CODING                                                                  (See Methods
ID                      CATEGORY                PROCEDURE                          Procedure   Procedure   Procedure




                                                                                                                                                                                        demand




                                                                                                                                                                                                                                                                          demand
     SPECIALTY                                                     (ICD-9-CM)                                                                   Tab for
                                                                                    Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                                                             Description of
                                                                                                                                               Process)




                 Operations on lymphatic                            40.2 40.3
8    GENERAL                                Lymphadenectomy
                 system                                             40.4 40.5




                                            Bone marrow or
                 Operations on bone
9    GENERAL                                hematopoietic stem         41.0
                 marrow and spleen
                                            cell transplant




                 Operations on bone
10   GENERAL                                Splenectomy             41.43 41.5
                 marrow and spleen




11   GENERAL     Operations on esophagus Esophagectomy                 42.4




12   GENERAL     Operations on esophagus Esophagomyotomy               42.7




                 Incision and excision of
13   GENERAL                                Gastrotomy                 43.0
                 stomach




                 Incision and excision of
14   GENERAL                                Pyloromyotomy              43.3
                 stomach




                                            Open extirpation of
15   GENERAL     Bariatric surgery
                                            lesion of stomach




                 Incision and excision of                         43.5 43.6 43.7
16   GENERAL                                Gastrectomy
                 stomach                                            43.8 43.9
                                                                                                                            % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                               Improved Technique/




                                                                                                                                                                                                           Population growth/




                                                                                                                                                                                                                                                   usage of technique
                                                                                                                                                                                                           greying population




                                                                                                                                                                                                                                                   Lower acceptance/
                                                                                                                                                                                                                                Higher Awareness
                                                                                                                                                                                     Higher Incidence/




                                                                                                                                                                                                                                                                        Lower incidence/
                                                                                     UK 2004     UK 2005     UK 2006




                                                                                                                                                                   Technology
     SURGICAL                                                         CODING                                                                  (See Methods
ID                      CATEGORY                PROCEDURE                           Procedure   Procedure   Procedure




                                                                                                                                                                                         demand




                                                                                                                                                                                                                                                                           demand
     SPECIALTY                                                      (ICD-9-CM)                                                                   Tab for
                                                                                     Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                                                              Description of
                                                                                                                                                Process)




                 Incision and excision of
17   GENERAL                                Vagotomy                    44.0
                 stomach




                                            Gastroenterostomy
                 Incision and excision of
18   GENERAL                                without gastrectomy         44.3
                 stomach
                                            (gastric bypass)




                                            Gastric Bypass,
19   GENERAL     Bariatric surgery
                                            laparoscopic




20   GENERAL     Bariatric surgery          Gastric Bypass, open




21   GENERAL     Operations on esophagus Fundoplication             Part of 44.66




22   GENERAL     Bariatric surgery          Gastroplasty            44.68 44.69




                                            (Laparoscopic)
                                            adjustment of size of
23   GENERAL     Bariatric Surgery                                     44.98
                                            adjustable gastric
                                            restrictive device



                 Incision, excision, and
24   GENERAL                                Enterotomy                  45.0
                 anastomosis of intestine




                 Incision, excision, and    Excision of small
25   GENERAL                                                         45.3, 45.63
                 anastomosis of intestine   intestine
                                                                                                                                % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                                   Improved Technique/




                                                                                                                                                                                                               Population growth/




                                                                                                                                                                                                                                                       usage of technique
                                                                                                                                                                                                               greying population




                                                                                                                                                                                                                                                       Lower acceptance/
                                                                                                                                                                                                                                    Higher Awareness
                                                                                                                                                                                         Higher Incidence/




                                                                                                                                                                                                                                                                            Lower incidence/
                                                                                         UK 2004     UK 2005     UK 2006




                                                                                                                                                                       Technology
     SURGICAL                                                            CODING                                                                   (See Methods
ID                     CATEGORY                 PROCEDURE                               Procedure   Procedure   Procedure




                                                                                                                                                                                             demand




                                                                                                                                                                                                                                                                               demand
     SPECIALTY                                                         (ICD-9-CM)                                                                    Tab for
                                                                                         Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                                                                  Description of
                                                                                                                                                    Process)




                 Incision, excision, and
26   GENERAL                                Small bowel resection   45.61 45.62 45.51
                 anastomosis of intestine




                 Incision, excision, and    Excision of large
27   GENERAL                                                           45.7 45.8
                 anastomosis of intestine   intestine




                 Other operations on
28   GENERAL                                Right hemicolectomy          45.73
                 intestine




                 Other operations on
29   GENERAL                                Transverse colectomy         45.74
                 intestine




                 Other operations on
30   GENERAL                                Left hemicolectomy           45.75
                 intestine




31   GENERAL     Colorectal surgery         Hartmann procedure




                 Operations on rectum,
32   GENERAL     rectosigmoid and           Sigmoidectomy                45.76
                 perirectal tissue




                                            Other colectomies
33   GENERAL     Colorectal surgery                                      45.79
                                            (incl. subtotal)




34   GENERAL     Colorectal surgery         Total colectomy
                                                                                                                              % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                                 Improved Technique/




                                                                                                                                                                                                             Population growth/




                                                                                                                                                                                                                                                     usage of technique
                                                                                                                                                                                                             greying population




                                                                                                                                                                                                                                                     Lower acceptance/
                                                                                                                                                                                                                                  Higher Awareness
                                                                                                                                                                                       Higher Incidence/




                                                                                                                                                                                                                                                                          Lower incidence/
                                                                                       UK 2004     UK 2005     UK 2006




                                                                                                                                                                     Technology
     SURGICAL                                                           CODING                                                                  (See Methods
ID                     CATEGORY                 PROCEDURE                             Procedure   Procedure   Procedure




                                                                                                                                                                                           demand




                                                                                                                                                                                                                                                                             demand
     SPECIALTY                                                        (ICD-9-CM)                                                                   Tab for
                                                                                       Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                                                                Description of
                                                                                                                                                  Process)




35   GENERAL     Colorectal surgery         Total proctocolectomy




                 Incision, excision, and
36   GENERAL                                Intestinal anastomosis        45.9
                 anastomosis of intestine




37   GENERAL     Colorectal surgery         J-Pouch procedure         Part of 45.95




                 Other operations on
38   GENERAL                                Colostomy                     46.1
                 intestine




                 Other operations on
39   GENERAL                                Ileostomy                     46.2
                 intestine




40   GENERAL     Operations on appendix     Appendectomy                  47.0




                                            Drainage of
41   GENERAL     Operations on appendix                                   47.2
                                            appendiceal abscess




                 Operations on rectum,
                                            Proctotomy, with and
42   GENERAL     rectosigmoid and                                         48.0
                                            without anterior repair
                 perirectal tissue




                                            Excision of rectal
43   GENERAL     Colorectal surgery                                      48.35
                                            adenoma
                                                                                                                                     % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                                        Improved Technique/




                                                                                                                                                                                                                    Population growth/




                                                                                                                                                                                                                                                            usage of technique
                                                                                                                                                                                                                    greying population




                                                                                                                                                                                                                                                            Lower acceptance/
                                                                                                                                                                                                                                         Higher Awareness
                                                                                                                                                                                              Higher Incidence/




                                                                                                                                                                                                                                                                                 Lower incidence/
                                                                                       UK 2004        UK 2005      UK 2006




                                                                                                                                                                            Technology
     SURGICAL                                                          CODING                                                                          (See Methods
ID                     CATEGORY              PROCEDURE                                Procedure      Procedure    Procedure




                                                                                                                                                                                                  demand




                                                                                                                                                                                                                                                                                    demand
     SPECIALTY                                                       (ICD-9-CM)                                                                           Tab for
                                                                                       Volumes        Volumes      Volumes       % Change '06 vs '05
                                                                                                                                                       Description of
                                                                                                                                                         Process)




                                         Reduction of rectal
44   GENERAL     Colorectal surgery
                                         mucosa




                 Operations on rectum,
                                         Abdomino-perineal
45   GENERAL     rectosigmoid and                                        48.5
                                         resection of anus
                 perirectal tissue




46   GENERAL     Colorectal surgery      Low anterior resection      Part of 48.63




47   GENERAL     Colorectal surgery      Rectopexy                   48.76 48.75




                                         Procedures on
48   GENERAL     Operations on anus                                      49.4        Not available
                                         Hemorrhoids




                                         Destruction of
49   GENERAL     Operations on anus                                  49.43, 49.44
                                         Hemorrhoids




50   GENERAL     Operations on anus      Hemorrhoidectomy               49.46




                                         Implantation of
51   GENERAL     Colorectal surgery                                                                              Not available
                                         artificial anal sphincter




                                         Division of anal
52   GENERAL     Operations on anus                                      49.5
                                         sphincter
                                                                                                                         % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                            Improved Technique/




                                                                                                                                                                                                        Population growth/




                                                                                                                                                                                                                                                usage of technique
                                                                                                                                                                                                        greying population




                                                                                                                                                                                                                                                Lower acceptance/
                                                                                                                                                                                                                             Higher Awareness
                                                                                                                                                                                  Higher Incidence/




                                                                                                                                                                                                                                                                     Lower incidence/
                                                                                  UK 2004     UK 2005     UK 2006




                                                                                                                                                                Technology
     SURGICAL                                                        CODING                                                                (See Methods
ID                     CATEGORY               PROCEDURE                          Procedure   Procedure   Procedure




                                                                                                                                                                                      demand




                                                                                                                                                                                                                                                                        demand
     SPECIALTY                                                     (ICD-9-CM)                                                                 Tab for
                                                                                  Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                                                           Description of
                                                                                                                                             Process)




53   GENERAL     Operations on anus       Repair of anus              49.7




                                          Other repair of anal
54   GENERAL     Colorectal surgery                                   49.79
                                          sphincter




55   GENERAL     Operations on liver      Hepatotomy                  50.0




                                          Hepatectomy (partial +
56   GENERAL     Operations on liver                               50.22 50.4
                                          complete)




57   GENERAL     Operations on liver      Lobectomy of liver          50.3




58   GENERAL     Operations on liver      Liver transplant            50.5




                 Operations on gallbladder
59   GENERAL                               Cholecystectomy            51.2
                 and biliary tract




                 Operations on gallbladder
60   GENERAL                               Open cholecystectomy    51.21 51.22
                 and biliary tract




                 Operations on gallbladder Laparoscopic
61   GENERAL                                                       51.23 51.24
                 and biliary tract         cholecystectomy
                                                                                                                           % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                              Improved Technique/




                                                                                                                                                                                                          Population growth/




                                                                                                                                                                                                                                                  usage of technique
                                                                                                                                                                                                          greying population




                                                                                                                                                                                                                                                  Lower acceptance/
                                                                                                                                                                                                                               Higher Awareness
                                                                                                                                                                                    Higher Incidence/




                                                                                                                                                                                                                                                                       Lower incidence/
                                                                                    UK 2004     UK 2005     UK 2006




                                                                                                                                                                  Technology
     SURGICAL                                                           CODING                                                               (See Methods
ID                     CATEGORY                 PROCEDURE                          Procedure   Procedure   Procedure




                                                                                                                                                                                        demand




                                                                                                                                                                                                                                                                          demand
     SPECIALTY                                                        (ICD-9-CM)                                                                Tab for
                                                                                    Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                                                             Description of
                                                                                                                                               Process)




                 Operations on gallbladder Anastomosis of
62   GENERAL                                                             51.3
                 and biliary tract         gallbladder or bile duct




                 Operations on gallbladder Pancreatectomy -
63   GENERAL                                                            52.52
                 and biliary tract         distal




                                            Repair of inguinal
64   GENERAL     Repair of hernia                                     53.0 53.1
                                            hernia




                                            Inguinal herniorrhaphy,
65   GENERAL     Repair of hernia
                                            laparoscopic




                                            Inguinal herniorrhaphy,
66   GENERAL     Repair of hernia
                                            open




                                            Repair of femoral
67   GENERAL     Repair of hernia                                     53.2 53.3
                                            hernia




                                            Repair of recurrent
68   GENERAL     Repair of hernia           inguinal or femoral
                                            hernia




                                            Repair of umbilical
69   GENERAL     Repair of hernia                                        53.4
                                            hernia




                                            Repair of incisional
70   GENERAL     Repair of hernia                                       53.51
                                            hernia
                                                                                                                                 % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                                    Improved Technique/




                                                                                                                                                                                                                Population growth/




                                                                                                                                                                                                                                                        usage of technique
                                                                                                                                                                                                                greying population




                                                                                                                                                                                                                                                        Lower acceptance/
                                                                                                                                                                                                                                     Higher Awareness
                                                                                                                                                                                          Higher Incidence/




                                                                                                                                                                                                                                                                             Lower incidence/
                                                                                       UK 2004        UK 2005     UK 2006




                                                                                                                                                                        Technology
     SURGICAL                                                          CODING                                                                      (See Methods
ID                     CATEGORY                 PROCEDURE                             Procedure      Procedure   Procedure




                                                                                                                                                                                              demand




                                                                                                                                                                                                                                                                                demand
     SPECIALTY                                                       (ICD-9-CM)                                                                       Tab for
                                                                                       Volumes        Volumes     Volumes    % Change '06 vs '05
                                                                                                                                                   Description of
                                                                                                                                                     Process)




                 Other operations on
71   GENERAL                                Exploratory laparotomy      54.11
                 abdominal region




                 Other operations on        Lysis of peritoneal
72   GENERAL                                                             54.5
                 abdominal region           adhesions




                 Operations on rectum,
                                            Repair of Cystocele
73   GENERAL     rectosigmoid and                                       70.50
                                            and Rectocele
                 perirectal tissue




                 Operations on rectum,
74   GENERAL     rectosigmoid and           Cystocele repair            70.51
                 perirectal tissue




                 Operations on rectum,
75   GENERAL     rectosigmoid and           Rectocele repair            70.52
                 perirectal tissue




                 Operations on rectum,
                                            Obliteration of the
76   GENERAL     rectosigmoid and                                        70.8        Not available
                                            vaginal vault
                 perirectal tissue



                 Operations on rectum,
77   GENERAL     rectosigmoid and           Enterocele repair        Part of 70.92
                 perirectal tissue




78   GENERAL     Operations on the breast   Breast biopsy, needle       85.11




79   GENERAL     Operations on the breast   Breast biopsy, open         85.12




                                            Removal breast
80   GENERAL     Operations on the breast                                            Not available
                                            tumour
                                                                                                                                 % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                                                    Improved Technique/




                                                                                                                                                                                                                Population growth/




                                                                                                                                                                                                                                                        usage of technique
                                                                                                                                                                                                                greying population




                                                                                                                                                                                                                                                        Lower acceptance/
                                                                                                                                                                                                                                     Higher Awareness
                                                                                                                                                                                          Higher Incidence/




                                                                                                                                                                                                                                                                             Lower incidence/
                                                                                          UK 2004     UK 2005     UK 2006




                                                                                                                                                                        Technology
     SURGICAL                                                            CODING                                                                    (See Methods
ID                      CATEGORY                PROCEDURE                                Procedure   Procedure   Procedure




                                                                                                                                                                                              demand




                                                                                                                                                                                                                                                                                demand
     SPECIALTY                                                         (ICD-9-CM)                                                                     Tab for
                                                                                          Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                                                                   Description of
                                                                                                                                                     Process)




                                            Removal lesion of
81   GENERAL     Operations on the breast                                 85.21
                                            breast - lumpectomy




                                            Subcutaneous               85.33, 85.34
82   GENERAL     Operations on the breast
                                            mastectomy                 85.35, 85.36




83   GENERAL     Operations on the breast   Mastectomy                    85.4




                                            Simple mastectomy       85.41 85.42 + part
84   GENERAL     Operations on the breast
                                            (total mastectomy)       of 85.43 & 85.44




                                            Modified radical              Part of
85   GENERAL     Operations on the breast
                                            mastectomy                85.43 & 85.44




                                                                       85.45 85.46
86   GENERAL     Operations on the breast   Radical mastectomy
                                                                       85.47 85.48




                                            Operations on duct of
87   GENERAL     Operations on the breast
                                            breast




88   GENERAL     Bariatric surgery          Abdominoplasty            Part of 86.83




                 Operations on rectum,
89   GENERAL     rectosigmoid and           Sacro-colpo-fixation
                 perirectal tissue
                                                                                             % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                Improved Technique/




                                                                                                                                                                            Population growth/




                                                                                                                                                                                                                    usage of technique
                                                                                                                                                                            greying population




                                                                                                                                                                                                                    Lower acceptance/
                                                                                                                                                                                                 Higher Awareness
                                                                                                                                                      Higher Incidence/




                                                                                                                                                                                                                                         Lower incidence/
                                                      UK 2004     UK 2005     UK 2006




                                                                                                                                    Technology
     SURGICAL                             CODING                                                               (See Methods
ID               CATEGORY   PROCEDURE                Procedure   Procedure   Procedure




                                                                                                                                                          demand




                                                                                                                                                                                                                                            demand
     SPECIALTY                          (ICD-9-CM)                                                                Tab for
                                                      Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                               Description of
                                                                                                                 Process)
                                                                                             % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                Improved Technique/




                                                                                                                                                                            Population growth/




                                                                                                                                                                                                                    usage of technique
                                                                                                                                                                            greying population




                                                                                                                                                                                                                    Lower acceptance/
                                                                                                                                                                                                 Higher Awareness
                                                                                                                                                      Higher Incidence/




                                                                                                                                                                                                                                         Lower incidence/
                                                      UK 2004     UK 2005     UK 2006




                                                                                                                                    Technology
     SURGICAL                             CODING                                                               (See Methods
ID               CATEGORY   PROCEDURE                Procedure   Procedure   Procedure




                                                                                                                                                          demand




                                                                                                                                                                                                                                            demand
     SPECIALTY                          (ICD-9-CM)                                                                Tab for
                                                      Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                               Description of
                                                                                                                 Process)
                                                                                             % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                Improved Technique/




                                                                                                                                                                            Population growth/




                                                                                                                                                                                                                    usage of technique
                                                                                                                                                                            greying population




                                                                                                                                                                                                                    Lower acceptance/
                                                                                                                                                                                                 Higher Awareness
                                                                                                                                                      Higher Incidence/




                                                                                                                                                                                                                                         Lower incidence/
                                                      UK 2004     UK 2005     UK 2006




                                                                                                                                    Technology
     SURGICAL                             CODING                                                               (See Methods
ID               CATEGORY   PROCEDURE                Procedure   Procedure   Procedure




                                                                                                                                                          demand




                                                                                                                                                                                                                                            demand
     SPECIALTY                          (ICD-9-CM)                                                                Tab for
                                                      Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                               Description of
                                                                                                                 Process)
                                                                                             % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                Improved Technique/




                                                                                                                                                                            Population growth/




                                                                                                                                                                                                                    usage of technique
                                                                                                                                                                            greying population




                                                                                                                                                                                                                    Lower acceptance/
                                                                                                                                                                                                 Higher Awareness
                                                                                                                                                      Higher Incidence/




                                                                                                                                                                                                                                         Lower incidence/
                                                      UK 2004     UK 2005     UK 2006




                                                                                                                                    Technology
     SURGICAL                             CODING                                                               (See Methods
ID               CATEGORY   PROCEDURE                Procedure   Procedure   Procedure




                                                                                                                                                          demand




                                                                                                                                                                                                                                            demand
     SPECIALTY                          (ICD-9-CM)                                                                Tab for
                                                      Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                               Description of
                                                                                                                 Process)
                                                                                             % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                Improved Technique/




                                                                                                                                                                            Population growth/




                                                                                                                                                                                                                    usage of technique
                                                                                                                                                                            greying population




                                                                                                                                                                                                                    Lower acceptance/
                                                                                                                                                                                                 Higher Awareness
                                                                                                                                                      Higher Incidence/




                                                                                                                                                                                                                                         Lower incidence/
                                                      UK 2004     UK 2005     UK 2006




                                                                                                                                    Technology
     SURGICAL                             CODING                                                               (See Methods
ID               CATEGORY   PROCEDURE                Procedure   Procedure   Procedure




                                                                                                                                                          demand




                                                                                                                                                                                                                                            demand
     SPECIALTY                          (ICD-9-CM)                                                                Tab for
                                                      Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                               Description of
                                                                                                                 Process)
                                                                                             % Change            Process                                                  Confirmed Trend                                                                   Other




                                                                                                                                Improved Technique/




                                                                                                                                                                            Population growth/




                                                                                                                                                                                                                    usage of technique
                                                                                                                                                                            greying population




                                                                                                                                                                                                                    Lower acceptance/
                                                                                                                                                                                                 Higher Awareness
                                                                                                                                                      Higher Incidence/




                                                                                                                                                                                                                                         Lower incidence/
                                                      UK 2004     UK 2005     UK 2006




                                                                                                                                    Technology
     SURGICAL                             CODING                                                               (See Methods
ID               CATEGORY   PROCEDURE                Procedure   Procedure   Procedure




                                                                                                                                                          demand




                                                                                                                                                                                                                                            demand
     SPECIALTY                          (ICD-9-CM)                                                                Tab for
                                                      Volumes     Volumes     Volumes    % Change '06 vs '05
                                                                                                               Description of
                                                                                                                 Process)
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure   Indication on Subgroups    SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                                             National Databank and National
                                                                                      organisations




                                                                             National Databank and National
                                                                                      organisations




                                                                             National Databank and National
                                                                                      organisations




                                                                             National Databank and National
                                                                                      organisations




                                                                             National Databank and National
                                                                                      organisations




                                                                             National Databank and National
                                                                                      organisations




                                                                             National Databank and National
                                                                                      organisations
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure   Indication on Subgroups      SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                                              National Databank and National
                                                                                       organisations




                                                                                 National Databank, National
                                                                             organisations and Expert Interviews




                                                                              National Databank and National
                                                                                       organisations




                                                                              National Databank and National
                                                                                       organisations




                                                                              National Databank and National
                                                                                       organisations




                                                                              National Databank and National
                                                                                       organisations




                                                                              National Databank and National
                                                                                       organisations




                                                                              National Databank and National
                                                                                       organisations




                                                                              National Databank and National
                                                                                       organisations
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure      Indication on Subgroups           SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                                                      National Databank and National
                                                                                               organisations




                                                                                      National Databank and National
                                                                                               organisations




                                                   The Laparoscopic Gastric Bypass
                                                    procedures are a subset of the   National Organisations and Opinion
                                                      Gastroenterostomy without                   Leaders
                                                    gastrectomy procedures (44.3)




                                                   The Laparoscopic Gastric Bypass
                                                    procedures are a subset of the    National Databank and National
                                                      Gastroenterostomy without                organisations
                                                    gastrectomy procedures (44.3)




                                                                                      National Databank and National
                                                                                               organisations




                                                                                         National Databank, National
                                                                                     organisations and Expert Interviews




                                                                                      National Databank and National
                                                                                               organisations




                                                                                      National Databank and National
                                                                                               organisations




                                                                                      National Databank and National
                                                                                               organisations
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure        Indication on Subgroups                SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                                                             National Databank and National
                                                                                                      organisations




                                                                                             National Databank and National
                                                                                                      organisations




                                                    The Right hemicolectomies (45.73)
                                                                                             National Databank and National
                                                   are a subset of the Excisions of large
                                                                                                      organisations
                                                           Intestine (45.7 45.8)




                                                   The Transverse colectomies (45.74)
                                                                                             National Databank and National
                                                   are a subset of the Excisions of large
                                                                                                      organisations
                                                           Intestine (45.7 45.8)




                                                   The Left hemicolectomies (45.75) are
                                                                                             National Databank and National
                                                     a subset of the Excisions of large
                                                                                                      organisations
                                                            Intestine (45.7 45.8)




                                                                                                National Databank, National
                                                                                            organisations and Expert Interviews




                                                    The Sigmoidectomies (45.76) are a
                                                                                             National Databank and National
                                                     subset of the Excisions of large
                                                                                                      organisations
                                                           Intestine (45.7 45.8)




                                                   The Other colectomies (45.79) are a
                                                                                             National Databank and National
                                                     subset of the Excisions of large
                                                                                                      organisations
                                                          Intestine (45.7 45.8)




                                                                                             National Databank and National
                                                                                                      organisations
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure        Indication on Subgroups             SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                             National Databank, National
                                                                                         organisations and Expert Interviews




                                                   The J-Pouch procedures are a subset
                                                                                          National Databank and National
                                                       of the Intestinal Anastomosis
                                                                                                   organisations
                                                             procedures (45.9)




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                          National Databank and National
                                                                                                   organisations




                                                                                          National Databank and National
                                                                                                   organisations
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure        Indication on Subgroups           SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                         National Databank and National
                                                                                                  organisations




                                                     The Destruction of hemorrhoids
                                                     procedures (49.43, 49.44) are a     National Databank and National
                                                    subset of the Total Procedures on             organisations
                                                           hemorrhoids (49.4)




                                                   he Hemorrhoidectomies (49.46) are a
                                                                                         National Databank and National
                                                     subset of the Total procedures on
                                                                                                  organisations
                                                            hemorrhoids (49.4).




                                                                                         National Databank and National
                                                                                                  organisations




                                                                                         National Databank and National
                                                                                                  organisations
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure        Indication on Subgroups               SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                                                            National Databank and National
                                                                                                     organisations




                                                     The Other repair of anal sphincter
                                                                                            National Databank and National
                                                     Procedures (49.79) are a subset of
                                                                                                     organisations
                                                   the Repair of Anus Procedures (49.7)




                                                                                            National Databank and National
                                                                                                     organisations




                                                                                            National Databank and National
                                                                                                     organisations




                                                                                               National Databank, National
                                                                                           organisations and Expert Interviews




                                                                                            National Databank and National
                                                                                                     organisations




                                                                                            National Databank and National
                                                                                                     organisations




                                                        The Open Cholecystectomy
                                                                                            National Databank and National
                                                   Procedures (51.21 51.22) are a subset
                                                                                                     organisations
                                                      of all Cholecystectomies (51.2)




                                                   The Laparoscopic cholecystectomies
                                                                                            National Databank and National
                                                     (51.23 51.24) are a subset of all
                                                                                                     organisations
                                                        Cholecystectomies (51.2)
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure        Indication on Subgroups              SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                                                           National Databank and National
                                                                                                    organisations




                                                                                              National Databank, National
                                                                                          organisations and Expert Interviews




                                                                                           National Databank and National
                                                                                                    organisations




                                                       The Laparoscopic Inguinal
                                                     Herniorrhaphy Procedures are a        National Databank and National
                                                    subset of Repair of inguinal hernia             organisations
                                                               (53.0, 53.1).




                                                    The Open Inguinal Herniorrhaphy
                                                                                           National Databank and National
                                                   Procedures are a subset of Repair of
                                                                                                    organisations
                                                       inguinal hernia (53.0, 53.1).




                                                                                           National Databank and National
                                                                                                    organisations




                                                                                           National Databank and National
                                                                                                    organisations




                                                                                           National Databank and National
                                                                                                    organisations




                                                                                           National Databank and National
                                                                                                    organisations
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure        Indication on Subgroups               SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                                                            National Databank and National
                                                                                                     organisations




                                                                                               National Databank, National
                                                                                           organisations and Expert Interviews




                                                     The Cystocele/rectocele repairs
                                                                                               National Databank, National
                                                   (70.50) are a subset of the Repair of
                                                                                           organisations and Expert Interviews
                                                           prolapse procedures




                                                   The Cystocele repairs (70.51) are a
                                                                                            National Databank and National
                                                    subset of the Repair of prolapse
                                                                                                     organisations
                                                               procedures




                                                   The Rectocele repairs (70.52) are a
                                                                                            National Databank and National
                                                    subset of the Repair of prolapse
                                                                                                     organisations
                                                               procedures




                                                                                            National Databank and National
                                                                                                     organisations




                                                                                            National Databank and National
                                                                                                     organisations




                                                                                            National Databank and National
                                                                                                     organisations




                                                                                            National Databank and National
                                                                                                     organisations




                                                                                               National Databank, National
                                                                                           organisations and Expert Interviews
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure        Indication on Subgroups              SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes




                                                     The Lumpectomies (85.21) are a
                                                                                           National Databank and National
                                                     subset of the Removal of breast
                                                                                                    organisations
                                                           tumour procedures.




                                                                                           National Databank and National
                                                                                                    organisations




                                                   The Mastectomies (85.4) are a subset
                                                                                           National Databank and National
                                                     of the Removal of breast tumour
                                                                                                    organisations
                                                               procedures.




                                                     The Simple mastectomies are a         National Databank and National
                                                    subset of the Mastectomies (85.4)               organisations




                                                    The Modified radical mastectomies
                                                                                           National Databank and National
                                                     are a subset of the Mastectomies
                                                                                                    organisations
                                                                   (85.4)




                                                     The Radical mastectomies are a           National Databank, National
                                                    subset of the Mastectomies (85.4)     organisations and Expert Interviews




                                                                                           National Databank and National
                                                                                                    organisations




                                                                                           National Databank and National
                                                                                                    organisations




                                                                                           National Databank and National
                                                                                                    organisations
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure   Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure   Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure   Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure   Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure   Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes
FORECAST: UK     FORECAST: UK     FORECAST: UK
2007 Procedure   2008 Procedure   2009 Procedure   Indication on Subgroups   SOURCES/ASSUMPTIONS
   Volumes          Volumes          Volumes
                                                                                         France 2006   Germany 2006   Italy 2006   Spain 2006       UK 2006    TOTAL 2006
     SURGICAL                                                                 CODING
ID                     CATEGORY                    PROCEDURE                              Procedure     Procedure     Procedure    Procedure       Procedure    Procedure
     SPECIALTY                                                              (ICD-9-CM)
                                                                                           Volumes       Volumes       Volumes      Volumes         Volumes      Volumes




                 Operations on thyroid and
1    GENERAL                               Unilateral thyroid lobectomy        06.2
                 parathyroid glands




                 Operations on thyroid and
2    GENERAL                               Complete thyroidectomy              06.4
                 parathyroid glands




                 Operations on thyroid and
3    GENERAL                               Parathyroidectomy                   06.8
                 parathyroid glands




                 Operations on other
4    GENERAL                                Total adrenalectomy                07.3
                 endocrine glands




                 Operations on other
5    GENERAL                                Hypophysectomy                     07.6
                 endocrine glands




                 Operations on lymphatic    Incision of lymphatic
6    GENERAL                                                                   40.0
                 system                     structures




                 Operations on lymphatic
7    GENERAL                                Biopsy of lymphatic structure     40.11                                                Not available
                 system




                 Operations on lymphatic                                    40.2 40.3
8    GENERAL                                Lymphadenectomy
                 system                                                     40.4 40.5




                                            Bone marrow or
                 Operations on bone
9    GENERAL                                hematopoietic stem cell            41.0
                 marrow and spleen
                                            transplant




                 Operations on bone
10   GENERAL                                Splenectomy                     41.43 41.5
                 marrow and spleen




11   GENERAL     Operations on esophagus Esophagectomy                         42.4




12   GENERAL     Operations on esophagus Esophagomyotomy                       42.7




                 Incision and excision of
13   GENERAL                                Gastrotomy                         43.0
                 stomach
                                                                           France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                                                   CODING
ID                     CATEGORY                   PROCEDURE                 Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                                                (ICD-9-CM)
                                                                             Volumes       Volumes       Volumes      Volumes      Volumes      Volumes




                 Incision and excision of
14   GENERAL                                Pyloromyotomy        43.3
                 stomach
                                                                                             France 2006   Germany 2006     Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                                                                  CODING
ID                      CATEGORY                   PROCEDURE                                  Procedure     Procedure       Procedure    Procedure    Procedure    Procedure
     SPECIALTY                                                               (ICD-9-CM)
                                                                                               Volumes       Volumes         Volumes      Volumes      Volumes      Volumes




                                            Open extirpation of lesion of
15   GENERAL     Bariatric surgery
                                            stomach




                 Incision and excision of                                   43.5 43.6 43.7
16   GENERAL                                Gastrectomy
                 stomach                                                       43.8 43.9




                 Incision and excision of
17   GENERAL                                Vagotomy                             44.0
                 stomach




                 Incision and excision of   Gastroenterostomy without
18   GENERAL                                                                     44.3
                 stomach                    gastrectomy (gastric bypass)




19   GENERAL     Bariatric surgery          Gastric Bypass, laparoscopic




20   GENERAL     Bariatric surgery          Gastric Bypass, open




21   GENERAL     Operations on esophagus Fundoplication                      Part of 44.66




22   GENERAL     Bariatric surgery          Gastroplasty                     44.68 44.69                    Not available
                                                                                               France 2006     Germany 2006   Italy 2006      Spain 2006       UK 2006    TOTAL 2006
     SURGICAL                                                                   CODING
ID                     CATEGORY                    PROCEDURE                                    Procedure       Procedure     Procedure       Procedure       Procedure    Procedure
     SPECIALTY                                                                (ICD-9-CM)
                                                                                                 Volumes         Volumes       Volumes         Volumes         Volumes      Volumes




                                            (Laparoscopic) adjustment of
23   GENERAL     Bariatric Surgery          size of adjustable gastric          44.98          Not available                  Not available   Not available
                                            restrictive device




                 Incision, excision, and
24   GENERAL                                Enterotomy                           45.0
                 anastomosis of intestine




                 Incision, excision, and
25   GENERAL                                Excision of small intestine       45.3, 45.63
                 anastomosis of intestine




                 Incision, excision, and
26   GENERAL                                Small bowel resection          45.61 45.62 45.51
                 anastomosis of intestine




                 Incision, excision, and
27   GENERAL                                Excision of large intestine       45.7 45.8
                 anastomosis of intestine




                 Other operations on
28   GENERAL                                Right hemicolectomy                 45.73
                 intestine




                 Other operations on
29   GENERAL                                Transverse colectomy                45.74
                 intestine




                 Other operations on
30   GENERAL                                Left hemicolectomy                  45.75
                 intestine




31   GENERAL     Colorectal surgery         Hartmann procedure




                 Operations on rectum,
32   GENERAL     rectosigmoid and           Sigmoidectomy                       45.76
                 perirectal tissue
                                                                                           France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                                                                CODING
ID                     CATEGORY                    PROCEDURE                                Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                                                             (ICD-9-CM)
                                                                                             Volumes       Volumes       Volumes      Volumes      Volumes      Volumes




                                            Other colectomies (incl.
33   GENERAL     Colorectal surgery                                           45.79
                                            subtotal)




34   GENERAL     Colorectal surgery         Total colectomy




35   GENERAL     Colorectal surgery         Total proctocolectomy




                 Incision, excision, and
36   GENERAL                                Intestinal anastomosis             45.9
                 anastomosis of intestine




37   GENERAL     Colorectal surgery         J-Pouch procedure              Part of 45.95




                 Other operations on
38   GENERAL                                Colostomy                          46.1
                 intestine




                 Other operations on
39   GENERAL                                Ileostomy                          46.2
                 intestine




40   GENERAL     Operations on appendix     Appendectomy                       47.0




                                            Drainage of appendiceal
41   GENERAL     Operations on appendix                                        47.2
                                            abscess




                 Operations on rectum,
                                            Proctotomy, with and without
42   GENERAL     rectosigmoid and                                              48.0
                                            anterior repair
                 perirectal tissue
                                                                                           France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006        TOTAL 2006
     SURGICAL                                                                CODING
ID                     CATEGORY                  PROCEDURE                                  Procedure     Procedure     Procedure    Procedure    Procedure        Procedure
     SPECIALTY                                                             (ICD-9-CM)
                                                                                             Volumes       Volumes       Volumes      Volumes      Volumes          Volumes




43   GENERAL     Colorectal surgery      Excision of rectal adenoma           48.35




44   GENERAL     Colorectal surgery      Reduction of rectal mucosa




                 Operations on rectum,
                                         Abdomino-perineal resection
45   GENERAL     rectosigmoid and                                              48.5
                                         of anus
                 perirectal tissue




46   GENERAL     Colorectal surgery      Low anterior resection            Part of 48.63




47   GENERAL     Colorectal surgery      Rectopexy                         48.76 48.75




48   GENERAL     Operations on anus      Procedures on Hemorrhoids             49.4




49   GENERAL     Operations on anus      Destruction of Hemorrhoids        49.43, 49.44




50   GENERAL     Operations on anus      Hemorrhoidectomy                     49.46




                                         Implantation of artificial anal
51   GENERAL     Colorectal surgery                                                                                                               Not available
                                         sphincter
                                                                                          France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                                                                 CODING
ID                     CATEGORY                   PROCEDURE                                Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                                                              (ICD-9-CM)
                                                                                            Volumes       Volumes       Volumes      Volumes      Volumes      Volumes




52   GENERAL     Operations on anus        Division of anal sphincter          49.5




53   GENERAL     Operations on anus        Repair of anus                      49.7




54   GENERAL     Colorectal surgery        Other repair of anal sphincter      49.79




55   GENERAL     Operations on liver       Hepatotomy                          50.0




                                           Hepatectomy (partial +
56   GENERAL     Operations on liver                                        50.22 50.4
                                           complete)




57   GENERAL     Operations on liver       Lobectomy of liver                  50.3




58   GENERAL     Operations on liver       Liver transplant                    50.5




                 Operations on gallbladder
59   GENERAL                               Cholecystectomy                     51.2
                 and biliary tract




                 Operations on gallbladder
60   GENERAL                               Open cholecystectomy             51.21 51.22
                 and biliary tract




                 Operations on gallbladder Laparoscopic
61   GENERAL                                                                51.23 51.24
                 and biliary tract         cholecystectomy




                 Operations on gallbladder Anastomosis of gallbladder or
62   GENERAL                                                                   51.3
                 and biliary tract         bile duct
                                                                                       France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                                                               CODING
ID                     CATEGORY                   PROCEDURE                             Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                                                            (ICD-9-CM)
                                                                                         Volumes       Volumes       Volumes      Volumes      Volumes      Volumes




                 Operations on gallbladder
63   GENERAL                               Pancreatectomy - distal          52.52
                 and biliary tract




64   GENERAL     Repair of hernia          Repair of inguinal hernia      53.0 53.1




                                           Inguinal herniorrhaphy,
65   GENERAL     Repair of hernia
                                           laparoscopic




66   GENERAL     Repair of hernia          Inguinal herniorrhaphy, open




67   GENERAL     Repair of hernia          Repair of femoral hernia       53.2 53.3




                                           Repair of recurrent inguinal
68   GENERAL     Repair of hernia
                                           or femoral hernia




69   GENERAL     Repair of hernia          Repair of umbilical hernia        53.4




70   GENERAL     Repair of hernia          Repair of incisional hernia      53.51
                                                                                            France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                                                                 CODING
ID                     CATEGORY                    PROCEDURE                                 Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                                                              (ICD-9-CM)
                                                                                              Volumes       Volumes       Volumes      Volumes      Volumes      Volumes




                 Other operations on
71   GENERAL                                Exploratory laparotomy             54.11
                 abdominal region




                 Other operations on
72   GENERAL                                Lysis of peritoneal adhesions       54.5
                 abdominal region




                 Operations on rectum,
                                            Repair of Cystocele and
73   GENERAL     rectosigmoid and                                              70.50
                                            Rectocele
                 perirectal tissue




                 Operations on rectum,
74   GENERAL     rectosigmoid and           Cystocele repair                   70.51
                 perirectal tissue




                 Operations on rectum,
75   GENERAL     rectosigmoid and           Rectocele repair                   70.52
                 perirectal tissue




                 Operations on rectum,
                                            Obliteration of the vaginal
76   GENERAL     rectosigmoid and                                               70.8
                                            vault
                 perirectal tissue



                 Operations on rectum,
77   GENERAL     rectosigmoid and           Enterocele repair               Part of 70.92
                 perirectal tissue




78   GENERAL     Operations on the breast   Breast biopsy, needle              85.11




79   GENERAL     Operations on the breast   Breast biopsy, open                85.12




80   GENERAL     Operations on the breast   Removal breast tumour
                                                                                                France 2006   Germany 2006     Italy 2006      Spain 2006       UK 2006    TOTAL 2006
     SURGICAL                                                                   CODING
ID                      CATEGORY                   PROCEDURE                                     Procedure     Procedure       Procedure       Procedure       Procedure    Procedure
     SPECIALTY                                                                (ICD-9-CM)
                                                                                                  Volumes       Volumes         Volumes         Volumes         Volumes      Volumes




                                            Removal lesion of breast -
81   GENERAL     Operations on the breast                                        85.21
                                            lumpectomy




                                                                             85.33, 85.34
82   GENERAL     Operations on the breast   Subcutaneous mastectomy
                                                                             85.35, 85.36




83   GENERAL     Operations on the breast   Mastectomy                           85.4




                                            Simple mastectomy (total       85.41 85.42 + part
84   GENERAL     Operations on the breast
                                            mastectomy)                     of 85.43 & 85.44




                                                                                 Part of
85   GENERAL     Operations on the breast   Modified radical mastectomy
                                                                             85.43 & 85.44




                                                                             85.45 85.46
86   GENERAL     Operations on the breast   Radical mastectomy
                                                                             85.47 85.48




87   GENERAL     Operations on the breast   Operations on duct of breast                                       Not available   Not available   Not available




88   GENERAL     Bariatric surgery          Abdominoplasty                   Part of 86.83




                 Operations on rectum,
89   GENERAL     rectosigmoid and           Sacro-colpo-fixation
                 perirectal tissue
                                                     France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                             CODING
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                          (ICD-9-CM)
                                                       Volumes       Volumes       Volumes      Volumes      Volumes      Volumes
                                                     France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                             CODING
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                          (ICD-9-CM)
                                                       Volumes       Volumes       Volumes      Volumes      Volumes      Volumes
                                                     France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                             CODING
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                          (ICD-9-CM)
                                                       Volumes       Volumes       Volumes      Volumes      Volumes      Volumes
                                                     France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                             CODING
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                          (ICD-9-CM)
                                                       Volumes       Volumes       Volumes      Volumes      Volumes      Volumes
                                                     France 2006   Germany 2006   Italy 2006   Spain 2006    UK 2006    TOTAL 2006
     SURGICAL                             CODING
ID               CATEGORY   PROCEDURE                 Procedure     Procedure     Procedure    Procedure    Procedure    Procedure
     SPECIALTY                          (ICD-9-CM)
                                                       Volumes       Volumes       Volumes      Volumes      Volumes      Volumes
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                             Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                             Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                                Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason




                                                                                                                          The Laparoscopic Gastric Bypass
                                                                                                                           procedures are a subset of the
                                                                                                                             Gastroenterostomy without
                                                                                                                           gastrectomy procedures (44.3)




                                                                                                                          The Laparoscopic Gastric Bypass
                                                                                                                           procedures are a subset of the
                                                                                                                             Gastroenterostomy without
                                                                                                                           gastrectomy procedures (44.3)
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                                   Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason




                                                                                                                          The Right hemicolectomies (45.73) are
                                                                                                                            a subset of the Excisions of large
                                                                                                                                  Intestine (45.7 45.8)




                                                                                                                           The Transverse colectomies (45.74)
                                                                                                                           are a subset of the Excisions of large
                                                                                                                                   Intestine (45.7 45.8)




                                                                                                                          The Left hemicolectomies (45.75) are
                                                                                                                            a subset of the Excisions of large
                                                                                                                                   Intestine (45.7 45.8)




                                                                                                                           The Sigmoidectomies (45.76) are a
                                                                                                                             subset of the Excisions of large
                                                                                                                                  Intestine (45.7 45.8)
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                                  Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason




                                                                                                                          The Other colectomies (45.79) are a
                                                                                                                            subset of the Excisions of large
                                                                                                                                 Intestine (45.7 45.8)




                                                                                                                          The J-Pouch procedures are a subset
                                                                                                                              of the Intestinal Anastomosis
                                                                                                                                    procedures (45.9)
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                                 Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason




                                                                                                                            The Destruction of hemorrhoids
                                                                                                                            procedures (49.43, 49.44) are a
                                                                                                                           subset of the Total Procedures on
                                                                                                                                  hemorrhoids (49.4)




                                                                                                                          he Hemorrhoidectomies (49.46) are a
                                                                                                                           subset of the Total procedures on
                                                                                                                                 hemorrhoids (49.4).
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                                  Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason




                                                                                                                            The Other repair of anal sphincter
                                                                                                                          Procedures (49.79) are a subset of the
                                                                                                                            Repair of Anus Procedures (49.7)




                                                                                                                               The Open Cholecystectomy
                                                                                                                          Procedures (51.21 51.22) are a subset
                                                                                                                             of all Cholecystectomies (51.2)




                                                                                                                          The Laparoscopic cholecystectomies
                                                                                                                            (51.23 51.24) are a subset of all
                                                                                                                               Cholecystectomies (51.2)
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                                 Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason




                                                                                                                              The Laparoscopic Inguinal
                                                                                                                            Herniorrhaphy Procedures are a
                                                                                                                           subset of Repair of inguinal hernia
                                                                                                                                      (53.0, 53.1).




                                                                                                                           The Open Inguinal Herniorrhaphy
                                                                                                                          Procedures are a subset of Repair of
                                                                                                                              inguinal hernia (53.0, 53.1).
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                                 Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason




                                                                                                                            The Cystocele/rectocele repairs
                                                                                                                          (70.50) are a subset of the Repair of
                                                                                                                                  prolapse procedures




                                                                                                                          The Cystocele repairs (70.51) are a
                                                                                                                           subset of the Repair of prolapse
                                                                                                                                      procedures




                                                                                                                          The Rectocele repairs (70.52) are a
                                                                                                                           subset of the Repair of prolapse
                                                                                                                                      procedures
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                                  Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason



                                                                                                                            The Lumpectomies (85.21) are a
                                                                                                                            subset of the Removal of breast
                                                                                                                                  tumour procedures.




                                                                                                                          The Mastectomies (85.4) are a subset
                                                                                                                            of the Removal of breast tumour
                                                                                                                                     procedures.




                                                                                                                          The Simple mastectomies are a subset
                                                                                                                               of the Mastectomies (87.4)




                                                                                                                          The Modified radical mastectomies are
                                                                                                                           a subset of the Mastectomies (87.4)




                                                                                                                             The Radical mastectomies are a
                                                                                                                            subset of the Mastectomies (87.4)
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                             Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                             Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                             Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                             Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason
                                                                               Reason
FORECAST:    FORECAST:    FORECAST:
TOTAL 2007   TOTAL 2008   TOTAL 2009
                                                                    Change in                                             Indication on Subgroups
 Procedure    Procedure    Procedure   New technology/ new                              Clinical Reason/
  Volumes      Volumes      Volumes                          reimbursement system/                         Other reason
                                            technique                                      incidence
                                                                 financial reason

				
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