Carbon emissions during elective coronary artery bypass surgery, a single center experience

Hubert, Joshua; Gonzalez-Ciccarelli, Luis F.; Wang, Alexander W.; Toledo, Eduardo Coselli Vasco de; Ferrufino, Renan; Smalls, Kevin; Brovman, Ethan Y.; Cobey, Frederick C.

doi:10.1016/j.jclinane.2022.110850

Cited by 8 publications

(1 citation statement)

References 5 publications

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“…28 The choice of products used to perform a surgical operation is largely influenced by surgeons, and this study found, across observed operations, 54% of the total carbon footprint of products related to the production of single-use products. This was found to be 33 and New Zealand 34 (production including manufacture and distribution of single-use products responsible for 73% and 77% of the total for operation, respectively), cardiac surgery in France (86%) 35 coronary artery bypass graft in the United States (80%) 36 and hysterectomy in the United States (60%), 11 although the absolute proportions cited should be considered with caution, as different studies included different components of the operating theatre within their system boundary.…”

Section: Discussionmentioning

confidence: 99%

The carbon footprint of products used in five common surgical operations: identifying contributing products and processes

et al. 2023

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Objectives Mitigating carbon footprint of products used in resource-intensive areas such as surgical operating rooms will be important in achieving net zero carbon healthcare. The aim of this study was to evaluate the carbon footprint of products used within five common operations, and to identify the biggest contributors (hotspots). Design A predominantly process-based carbon footprint analysis was conducted for products used in the five highest volume surgical operations performed in the National Health System in England. Setting The carbon footprint inventory was based on direct observation of 6–10 operations/type, conducted across three sites within one NHS Foundation Trust in England. Participants Patients undergoing primary elective carpal tunnel decompression, inguinal hernia repair, knee arthroplasty, laparoscopic cholecystectomy, tonsillectomy (March 2019 – January 2020). Main outcome measures We determined the carbon footprint of the products used in each of the five operations, alongside greatest contributors through analysis of individual products and of underpinning processes. Results The mean average carbon footprint of products used for carpal tunnel decompression was 12.0 kg CO2e (carbon dioxide equivalents); 11.7 kg CO2e for inguinal hernia repair; 85.5 kg CO2e for knee arthroplasty; 20.3 kg CO2e for laparoscopic cholecystectomy; and 7.5 kg CO2e for tonsillectomy. Across the five operations, 23% of product types were responsible for ≥80% of the operation carbon footprint. Products with greatest carbon contribution for each operation type were the single-use hand drape (carpal tunnel decompression), single-use surgical gown (inguinal hernia repair), bone cement mix (knee arthroplasty), single-use clip applier (laparoscopic cholecystectomy) and single-use table drape (tonsillectomy). Mean average contribution from production of single-use items was 54%, decontamination of reusables 20%, waste disposal of single-use items 8%, production of packaging for single-use items 6% and linen laundering 6%. Conclusions Change in practice and policy should be targeted towards those products making greatest contribution, and should include reducing single-use items and switching to reusables, alongside optimising processes for decontamination and waste disposal, modelled to reduce carbon footprint of these operations by 23%–42%.

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