Advances in surgery: USA vs Europe

[firippusan]

Hi all,
my naive perception is that many medical innovations often happen in USA, and then are adopted in Europe. I would think the same happens for advances in surgery. However after watching many surgery vids online, I heard several instances where american surgeons asked about a recent technique, basically said there have been trials in Europe, but it is not yet approved in USA.

Two examples out of memory: total hip arthroplasty anterior approach: seems to have been done for many years in Europe, before some surgeons imported the technique to USA and it got approved (also reverse shoulder arthroplasty, but my memory might fail me). Aortic valve replacement (2009 vid), when asked whether catheter based approaches were possible, same answer as above, i.e. trials in Europe etc.

Are these just special cases, or is it a general phenomena? If so what are the reasons? Regulations?

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[vhawk]

The main reason is that there are a lot of surgeons in the world, and not all of them are in the US.

 

[Winged Scapula]

Like @vhawk noted, there are a lot of surgeons and even <gasp> excellent ones outside of the US.

In addition, without some of the strict regulatory bodies we have, like the FDA, it can be easier to get trials up and running.

And as always, our litigation environment.

 

[ItinerantSurgeon]

Gents, like with most other things, U.S. surgeons are #1. Royalty travel from all over the world to be operated on in the U.S. When I was a rez we had an international fellar from England or Scotland or one of them British places who was in his 10th year of training as a general surgeon. No joke. We make Heavy general surgeons in half that time here in the States. He also said they work only 35 hours a week as surgery residents. I've worked more hours that that in a day. They don't even call surgeons Dr over there, they're called Mr. True story, look it up.

 

[mimelim]

Hi all,
my naive perception is that many medical innovations often happen in USA, and then are adopted in Europe. I would think the same happens for advances in surgery. However after watching many surgery vids online, I heard several instances where american surgeons asked about a recent technique, basically said there have been trials in Europe, but it is not yet approved in USA.

Two examples out of memory: total hip arthroplasty anterior approach: seems to have been done for many years in Europe, before some surgeons imported the technique to USA and it got approved (also reverse shoulder arthroplasty, but my memory might fail me). Aortic valve replacement (2009 vid), when asked whether catheter based approaches were possible, same answer as above, i.e. trials in Europe etc.

Are these just special cases, or is it a general phenomena? If so what are the reasons? Regulations?

Like @vhawk noted, there are a lot of surgeons and even <gasp> excellent ones outside of the US.

In addition, without some of the strict regulatory bodies we have, like the FDA, it can be easier to get trials up and running.

And as always, our litigation environment.

In vascular surgery, we are 5 years behind Europe in terms of tech. If you want the latest and greatest, you have to go over there. Anything and everything endo is done in Europe before the US purely for regulatory reasons. The cost differential of bringing a device to market is like 1/3rd. It is not going to change any time soon.