The Carbon Footprint of Single-Use Flexible Cystoscopes Compared with Reusable Cystoscopes

Hogan, Donnacha; Kinnear, Ned; Hennessey, Derek

doi:10.1089/end.2021.0891

Cited by 27 publications

(18 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our lifecycle model, the carbon footprint of reusable cystoscopes was substantially less than that of SU cystoscopes, regardless of the reprocessor used or the case volume of the practice. This was due primarily to lower overall and per‐case reprocessing costs as the automatic endoscope reprocessors used only 0.3–0.9 kW/scope, compared to power estimates up to 10.5 kW described in other studies [11]. Consistent with prior micro‐costing studies comparing SU and reusable cystoscopes [23] the primary contributor to the per‐case carbon cost of reusable devices in the present was energy consumption of reprocessing.…”

Section: Discussionsupporting

confidence: 82%

“…However, these findings may not extrapolate to cystoscopes due to inherent differences between the devices, as well as higher breakage rates for ureteroscopes, which require more frequent maintenance and major and minor repairs. Recent studies comparing SU and reusable cystoscopes suggested that reusable scopes had a greater environmental impact, primarily due to their higher reprocessing costs [9,11]. However, these studies were limited by a relatively short duration of data collection, incomplete lifecycle analysis of SU cystoscopes, or lack of accounting for environmental impact based on carbon cost (kg CO 2 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Environmental impact of single‐use and reusable flexible cystoscopes

et al. 2023

View full text Add to dashboard Cite

To compare the carbon footprint and environmental impact of single-use and reusable flexible cystoscopes. Materials and MethodsWe analysed the expected clinical lifecycle of single-use (Ambu aScope TM 4 Cysto) and reusable (Olympus CYF-V2) flexible cystoscopes, from manufacture to disposal. Performance data on cumulative procedures between repairs and before decommissioning were derived from a high-volume multispecialty practice. We estimated carbon expenditures per-case using published data on endoscope manufacturing, energy consumption during transportation and reprocessing, and solid waste disposal. ResultsA fleet of 16 reusable cystoscopes in service for up to 135 months averaged 207 cases between repairs and 3920 cases per lifecycle. Based on a manufacturing carbon footprint of 11.49 kg CO 2 /kg device for reusable flexible endoscopes and 8.54 kg CO 2 /kg device for single-use endoscopes, the per-case manufacturing cost was 1.37 kg CO 2 for single-use devices and 0.0017 kg CO 2 for reusable devices. The solid mass of single-use and reusable devices was 0.16 and 0.57 kg, respectively. For reusable devices, the energy consumption of reusable device reprocessing using an automated endoscope reprocessor was 0.20 kg CO 2 , and per-case costs of device repackaging and repair were 0.005 and 0.02 kg CO 2 , respectively. The total estimated per-case carbon footprint of single-use and reusable devices was 2.40 and 0.53 kg CO 2 , respectively, favouring reusable devices. ConclusionIn this lifecycle analysis, the environmental impact of reusable flexible cystoscopes is markedly less than single-use cystoscopes. The primary contributor to the per-case carbon cost of reusable devices is energy consumption of reprocessing.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Environmental impact of single‐use and reusable flexible cystoscopes

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Davis et al [38] performed the only study to date comparing the carbon footprint of suFURS and rFURS and found that the single-use LithoVue TM resulted in marginally less carbon emission per case than the reusable Olympus URF-V TM (4.45 kg vs 4.47 kg of CO 2 ). Hogan et al [39] reported significantly lower emissions for the single-use Ambu aScope 4 Cysto TM compared to the reusable Olympus CYF-V2 TM (2.41 kg vs 4.23 kg of CO 2 per case; P < 0.0001) for patients undergoing flexible cystoscopy. These findings were then supported by Boucheron et al, who reported significantly reduced water consumption and waste production with the Ambu aScope 4 Cysto TM when compared to rFC [40].…”

Section: Discussionmentioning

confidence: 99%

Perspectives on technology: to use or to reuse, that is the endoscopic question—a systematic review of single‐use endoscopes

Anderson,

Patterson,

Skolarikos

et al. 2023

BJU International

View full text Add to dashboard Cite

IntroductionThere is a growing interest in single‐use endoscopes within urology, with multiple new devices now available. Although these devices have been evaluated to show efficacy on benchtop‐models, there is a paucity of data comparing clinical outcomes. The aim of this meta‐analysis was to compare clinical outcomes of single‐use endoscopes to reusable endoscopes to better define their role within urology.MethodsA systematic search of electronic databases was performed. All studies comparing clinical outcomes of participants undergoing urological procedures with single‐use endoscopes to those treated with reusable endoscopes were included. Results are reported in accordance with the PRISMA 2020 statement.ResultsTwenty‐one studies on 3943 participants were identified. Six different single‐use flexible ureteroscopes and two different single‐use flexible cystoscopes were assessed. There were no differences in mean post‐operative infection rates (4.0% vs 4.4%, p=0.87) or overall complication rates (11.5% vs 11.9%, p=0.88) between single‐use and reusable endoscopes. For patients undergoing flexible ureteroscopy there were no differences in operative time (mean difference ‐0.05 minutes, p=0.96), hospital length of stay (mean difference 0.06 days, p=0.18), or stone‐free rates (74% vs 74.3%, p=0.54) between the single‐use and reusable flexible ureteroscope groups.ConclusionThis study is the largest to compare clinical outcomes of single‐use endoscopes to reusable endoscopes within urology, and has demonstrated no difference in LOS, complication rates and SFR, with a reduced OT associated with single‐use FC. It also highlights that the cost‐efficiency and environmental impact of single‐use endoscopes is largely dependent on the caseload and reprocessing facilities available within a given institution. Urologists can therefore feel confident that whether they choose to “use, or to reuse” for the financial and environmental implications, they can do so without negatively impacting patient outcomes.

show abstract

“…They did this by examining carbon dioxide emissions, measuring device packaging wastes, measuring the solid wastes generated during the procedures, and analyzing the carbon footprint created through transporting cystoscopes from the manufacturer. 14 Our urology practice recycles 100% of the disposable cystoscopes that are utilized.…”

Section: Discussionmentioning

confidence: 99%

“…Hogan et al found that the disposable cystoscopes have less of an impact on the environment than reusable cystoscopes. 14 The Boucheron study had found that disposable cystoscopes were more environmentally friendly through analyzing waste and water consumption. 4 Hogan et al looked specifically at the impact of cystoscopy on the carbon footprint and landfills.…”

Section: Discussionmentioning

confidence: 99%

Conversion to Disposable Cystoscopes Decreased Post-procedure Encounters and Infections Compared to Reusable Cystoscopes

et al. 2023

View full text Add to dashboard Cite

Introduction:We evaluated for differences in post-procedure 30-day encounters or infections following office cystoscopy using disposable vs reusable cystoscopes.Methods: Cystoscopies performed from June to September 2020 and from February to May 2021 in our outpatient practice were retrospectively reviewed. The 2020 cystoscopies were performed with reusable cystoscopes, and the 2021 cystoscopies were performed with disposable cystoscopes. The primary outcome was the number of post-procedural 30-day encounters defined as phone calls, patient portal messages, emergency department visits, hospitalizations, or clinic appointments related to post-procedural complications such as dysuria, hematuria, or fever. Culture-proven urinary tract infection within 30 days of cystoscopy was evaluated as a secondary outcome. Results:We identified 1,000 cystoscopies, including 494 with disposable cystoscopes and 506 with reusable cystoscopes. Demographics were similar between groups. The most common indication for cystoscopy in both groups was suspicion of bladder cancer (disposable: 153 [30.2%] and reusable: 143 [28.9%]). Reusable cystoscopes were associated with a higher number of 30-day encounters (35 [7.1%] vs 11 [2.2%], P < .001), urine cultures (73 [14.8%] vs 3 [0.6%], P ¼ .005), and hospitalizations attributable to cystoscopy (1 [0.2%] vs 0 [0%], P < .001) than the disposable scope group. Positive urine cultures were also significantly more likely after cystoscopy with a reusable cystoscope (17 [3.4%] vs 1 [0.2%], P < .001).Conclusions: Disposable cystoscopes were associated with a lower number of post-procedure encounters and positive urine cultures compared to reusable cystoscopes.

show abstract

The Carbon Footprint of Single-Use Flexible Cystoscopes Compared with Reusable Cystoscopes

Cited by 27 publications

References 19 publications

Environmental impact of single‐use and reusable flexible cystoscopes

Environmental impact of single‐use and reusable flexible cystoscopes

Perspectives on technology: to use or to reuse, that is the endoscopic question—a systematic review of single‐use endoscopes

Conversion to Disposable Cystoscopes Decreased Post-procedure Encounters and Infections Compared to Reusable Cystoscopes

Contact Info

Product

Resources

About