In Europe, adoption of some minimally invasive procedures, such as transcatheter heart valve placements, has been really strong. However, there is another area where the uptake of minimally invasive procedures in the region has been notably lacking. The adoption of both laparoscopy and arthroscopy is much lower in Europe compared to the US, even though the technique was actually developed in Europe. This trend is particularly noticeable for arthroscopy about 1.45 million arthroscopy procedures were performed in the big 5 European countries in 2011 compared to more than 3.6 million in the US this is a big difference even taking population differences into account.

This is potentially partially a result of much higher outpatient procedure volumes in the US, while in many countries in Europe patients are still kept in the hospital overnight after a laparoscopic or arthroscopic intervention. As a result, the cost advantage of undergoing laparoscopy or arthroscopy compared to open surgery wouldn't be as substantial in Europe as in the US.

Nonetheless, interest in outpatient surgery is rising in Europe, particularly in France. In that country, the Health Authority (Haute Autorité de Santé) has acknowledged the advantages of outpatient (or day surgery) procedures, recognizing that the risk of infection is lower and that recovery is ultimately faster. According to the Health Authority's website, only 37% of surgeries are currently performed as an outpatient procedure in the country. The French government has therefore set a plan in place to improve this statistic over the next few years, which should boost arthroscopy and laparoscopy volumes.

Maybe if endoscopy device companies can convince more European regulatory bodies of these potential cost advantages, they can persuade other countries to follow suit.

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