Making minimally invasive procedures more sustainable: A systematic review comparing the environmental footprint of single‐use versus multi‐use instruments

Author:

Martins Russell Seth1ORCID,Salar Hashim2,Salar Musa2,Luo Jeffrey1,Poulikidis Kostantinos1,Razi Syed Shahzad1,Latif M. Jawad1,Tafuri Kyle3,Bhora Faiz Y.1

Affiliation:

1. Division of Thoracic Surgery Department of Surgery Hackensack Meridian Health Network Edison New Jersey USA

2. Medical College Aga Khan University Karachi Sindh Pakistan

3. Sustainability Hackensack Meridian Health Network Edison New Jersey USA

Abstract

AbstractBackgroundHealthcare systems contribute 5%–10% of the global carbon footprint. Given the detrimental impact of climate change on population health, health systems must seek to address this environmental responsibility. This is especially relevant in the modern era of minimally invasive procedures (MIP) where single‐use instruments are increasingly popular. We compared the environmental footprint of single‐use versus multi‐use instruments in MIP.MethodsWe conducted a systematic review across five databases to identify relevant original studies, following the PRISMA guidelines. We extracted environmental impact data and performed a quality assessment of included studies.ResultsWe included 13 studies published between 2005 and 2024. Eight employed Life Cycle Analysis (LCAs), which is the gold standard methodology for studies evaluating environmental impact. The instruments studied included laparoscopy systems, endoscopes, cystoscopes, bronchoscopes, duodenoscopes, and ureteroscopes. Six studies, including three high quality LCAs and one fair quality LCA, showed that single‐use instruments have a significantly higher environmental footprint than their multi‐use counterparts. Six studies suggested a lower environmental footprint for single‐use instruments, and one study presented comparable results. However, these studies were of poor/fair quality.ConclusionAlthough our systematic review yielded mixed results, all high quality LCAs suggested multi‐use instruments may be more environmentally friendly than their single‐use counterparts. Our findings are limited by inter‐study heterogeneity and methodological quality. There is an urgent need for additional research employing gold standard methodologies to explore the interplay between environmental impact and operational factors such as workflow efficiency and cost‐benefit ratio to allow health systems to make more informed decisions.

Publisher

Wiley

Reference35 articles.

1. Parmesan C. M. D.Morecroft andY.Trisurat.2022.Climate change 2022: Impacts adaptation and vulnerability: GIEC.

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3. The carbon footprint of surgical operations: a systematic review update

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