A Standardized Method for Estimating the Carbon Footprint of Disposable Minimally Invasive Surgical Devices

Abstract

Objective: To propose a standardized methodology for estimating the embodied carbon footprint (CF) of disposable minimally-invasive surgical devices (MISDs) and their application in new benign prostatic hyperplasia (BPH) MISDs. Summary of Background Data: The estimation of the CO2e emissions of disposable surgical devices is central to empowering the healthcare supply chain. Methods: The proposed methodology relied on a partial product lifecycle assessment and was restricted to a specific part of scope 3, which comprised the manufacturing of surgical device- and non–device-associated products (NDAPs), including packaging and user manual. The process-sum inventory method was used, which involves collecting data on all the component processes underpinning disposable MISDs. The seven latest disposable MISDs used worldwide for transurethral prostatic surgery were dismantled, and each piece was categorized, sorted into the appropriate raw material group, and weighed. The CF was estimated according to the following formula: activity data (weight of raw material) × emission factors of the corresponding raw material (kg CO2e/kg). Results: The total weights of disposable packaging and user manuals ranged from 0.062 to 1.013 kg. Plastic was the most common and least emissive raw material (2.38 kg CO2e/kg) identified. The estimated embodied CF of MISDs ranged from 0.07 to 3.3 kg CO2e, of which 9% to 86% was attributed to NDAPs. Conclusions: This study described a simple and independent calculation method for estimating the embodied CF of MISDs. Using this method, our results showed a wide discrepancy in the estimated CO2 emissions of the most recent disposable MISDs for transurethral BPH surgery. Thus, the lack of CF information should be of major concern in the development of future MISDs.

Environmental effects of surgical procedures and strategies for sustainable surgery

“…Finally, for the surgery itself, surgical packs of sterile instruments are frequently opened before surgery begins 50 . Eighty per cent of surgical solid waste is generated before the patient enters the operating theatre, and most of this waste is associated with packaging 51 , 52 . There is a lack of robust evidence on how much waste could be avoided if sterile pack openings were delayed until the start of surgery.…”

“…In England, 80% of operating theatre waste is generated preoperatively, 90% is misallocated and 40% is potentially recyclable. Thus, implementing and disseminating the recycling process in the operating theatre and beyond is crucial 52 , 63 , 80 .…”

“…Scales to standardize carbon footprint measurement have been developed, such as the Spark2 (ref. 91 ) for the broad surgical process or those described by Misrai et al 52 for the evaluation of disposable minimally invasive surgical devices 52 , 91 . Technology that will allow for global implementation of these scales is under development, and this will warrant a systematic measurement and identify health-care sectors in which sustainable intervention is necessary ( Open Medical ).…”

Variability in pediatric appendectomy: The association between disposable supply cost and procedure duration

“…The carbon footprint for disposable operating room supplies has been estimated between 0.07 (for transurethral prostate surgery) and 505 (for robotic hysterectomy) kilograms of carbon-dioxide equivalent, the latter of which is comparable to driving more than 1,500 miles in an average petrol car. 28,29 Reducing the use of laparoscopic disposable supplies can lower carbon-dioxide emissions from supply manufacturing, transport, and waste disposal. Importantly, reusable laparoscopic supplies also have economic and environmental costs, related to supply sterilization and maintenance.…”

How Interventional Pulmonologists Can Address Climate Change

“…These are packaged in plastic and nondegradable material. The industry should develop reusable devices packaged in recyclable and environmentally friendly materials b) Reduce Waste Production at All Steps in the Care Pathway (before, during, and after an IP Procedure) A recent study proposed a simplified method to estimate the carbon footprint of disposable surgical devices in urology and showed that up to 86% of GHG emissions were attributed to disposable packaging and user manuals [17]. Gastroenterology procedures are very similar to IP procedures.…”