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September 1997

Surgical Operations in the United StatesThen (1983) and Now (1994)

Author Affiliations

From the University of Medicine and Dentistry of New Jersey, Newark, and The Hernia Center, Freehold, NJ.

Arch Surg. 1997;132(9):983-990. doi:10.1001/archsurg.1997.01430330049007

Objective:  To study the hypothesis that numbers of surgical operations in the United States have increased from 1983 and 1994.

Design:  Analysis of data from the National Center for Health Statistics.

Setting:  Short-stay general and specialty noninstitutional hospitals, and freestanding ambulatory surgical facilities, exclusive of federal, military, and Veterans Affairs hospitals.

Patients:  Five-percent national sample.

Main Outcome Measure:  Ten most frequent surgical operations or classes of surgical procedures within neurosurgery, ophthalmology, otorhinolaryngology, cardiothoracic surgery, general surgery, urology, obstetrics and gynecology, and orthopedics.

Results:  In 1994, the 10 most frequently performed surgical operations in the United States totaled 7 929 000 cases. This contrasted with 5 731 000 top 10 procedures in 1983, or an increase of 38%. The most common surgical operation in 1994 was cataract extraction, totaling 2 049 000 cases. Groin herniorrhaphy (689 000 procedures) remained the most common operation performed by a general surgeon. Cesarean section was the most frequently completed obstetrical-gynecological operation (858 000 procedures) and the country's second most common surgical procedure in 1994. Arthroscopy of the knee (632 000 procedures) demonstrated enormous growth (153%) and was the country's seventh most frequent operation in 1994. Transurethral prostatectomy (229 000 procedures) underwent the most precipitous decline (29%) of any No. 1—ranked specialty procedure.

Conclusions:  Numbers of top 10 surgical operations have increased in every surgical specialty except obstetricsgynecology. Explanations may be the presence of new technologies, willingness of a preexisting reservoir of patients to undergo now less anxiety-provoking procedures, or less stringent indications.Arch Surg. 1997;132:983-990