Carbon footprint of robotically‐assisted laparoscopy, laparoscopy and laparotomy: a comparison

Woods, Demetrius L.; McAndrew, Thomas; Nevadunsky, Nicole S.; Hou, June Y.; Goldberg, Gary L.; Kuo, Dennis Yi-Shin; Isani, Sara

doi:10.1002/rcs.1640

Cited by 79 publications

(72 citation statements)

References 19 publications

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“…With regard to CO 2 production and energy consumption, Woods et al investigated 150 procedures (laparotomy, conventional laparoscopy and robot-assisted laparoscopy) demonstrating a consumption of 40.3 kg CO 2 /patient for robotassisted surgery. This was 38% higher than CO 2 production caused by conventional laparoscopy and 77% higher than that of open surgery [27].…”

Section: Discussionmentioning

confidence: 66%

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

et al. 2020

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Purpose Open simple prostatectomy (OSP) is a standard surgical technique for patients with benign prostatic hyperplasia with prostate size larger than 80 ml. As a minimally invasive approach, robot-assisted simple prostatectomy (RASP) emerged as a feasible surgical alternative. Currently, there are no definite recommendations for the standard use of RASP. Therefore, we aimed at investigating various clinical outcomes comparing RASP with OSP. Methods In this retrospective single-center study, we evaluated clinical data from 103 RASP and 31 OSP patients. Both cohorts were compared regarding different clinical characteristics with and without propensity score matching. To detect independent predictive factors for clinical outcomes, multivariate logistic regression analysis was performed. Results Robot-assisted simple prostatectomy patients demonstrated a lower estimated blood loss and need for postoperative blood transfusions as well as less postoperative complications. OSP had a shorter operative time (125 min vs. 182 min) longer hospital stay (11 days vs. 9 days) and longer time to catheter removal (8 days vs. 6 days). In the multivariate analysis, RASP was identified as an independent predictor for longer operative time, lower estimated blood loss, shorter length of hospital stay, shorter time to catheter removal, less postoperative complications and blood transfusions. Conclusion Robot-assisted simple prostatectomy is a safe alternative to OSP with less perioperative and postoperative morbidity. Whether OSP (shorter operative time) or RASP (shorter length of hospital stay) has a more favorable economic impact depends on the particular conditions of different health care systems. Further prospective comparative research is warranted to define the value of RASP in the current surgical management of benign prostatic hyperplasia.

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Section: Discussionmentioning

confidence: 66%

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

et al. 2020

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“…Following application of the inclusion and exclusion criteria, eight studies were found to be eligible. (7,26,27,(31)(32)(33)(34)(35) Of these, four were conducted exclusively in the US, (7,31,33,35) two in the UK, (27,32), one in Chile (26), and one in India (Table 1). (34) Variation in methods for carbon footprinting (Table 1)…”

Section: Study Selectionmentioning

confidence: 99%

The Carbon Footprint of Surgical Operations

et al. 2020

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Summary of background data and objectives: Operating theatres are typically the most resource-intensive area of a hospital, 3–6 times more energy-intensive than the rest of the hospital and a major contributor of waste. The primary objective of this systematic review was to evaluate existing literature calculating the carbon footprint of surgical operations, determining opportunities for improving the environmental impact of surgery. Methods: A systematic review was conducted in accordance with PRISMA guidelines. The Cochrane Database, Embase, Ovid MEDLINE, and PubMed were searched and inclusion criteria applied. The study endpoints were extracted and compared, with the risk of bias determined. Results: A total of 4604 records were identified, and 8 were eligible for inclusion. This review found that the carbon footprint of a single operation ranged 6–814 kg carbon dioxide equivalents. The studies found that major carbon hotspots within the examined operating theatres were electricity use, and procurement of consumables. It was possible to reduce the carbon footprint of surgery through improving energy-efficiency of theatres, using reusable or reprocessed surgical devices and streamlining processes. There were significant methodological limitations within included studies. Conclusions: Future research should focus on optimizing the carbon footprint of operating theatres through streamlining operations, expanding assessments to other surgical contexts, and determining ways to reduce the footprint through targeting carbon hotspots.

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“…Unlike other specialties, the environmental footprint of both of these procedures have been analysed in prior studies. 19,20,28,29 Additionally, ObGyn physicians work with, in general, patients who are highly motivated to improve environmental conditions.…”

Section: Introductionmentioning

confidence: 99%

Attitude of US obstetricians and gynaecologists to global warming and medical waste

Thiel

Duncan²,

Woods

2017

J Health Serv Res Policy

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Objectives Global warming (or climate change) is a major public health issue, and health services are one of the largest contributors to greenhouse gas emissions in high-income countries. Despite the scale of the health care sector's resource consumption, little is known about the attitude of physicians and their willingness to participate in efforts to reduce the environmental impact of health services. Methods A survey of 236 obstetricians and gynaecologists at the University of Pittsburgh Medical Center in Western Pennsylvania, USA. Survey responses were compared to Gallup poll data from the general population using a one-sample test of proportions, Fisher's exact tests, Chi-square test, and logistic regression. Results Physicians in obstetrics and gynaecology were more likely than the public (84% vs. 54%; p<0.001) to believe that global warming is occurring, that media portrayal of its seriousness is accurate, and that it is caused by human activities. Two-thirds of physicians felt the amount of surgical waste generated is excessive and increasing. The majority (95%) would support efforts to reduce waste, with 66% favouring the use of reusable surgical tools over disposable where clinically equivalent. Despite their preference for reusable surgical instruments, only 20% preferred the reusable devices available to them. Conclusions Health care providers engaging in sustainability efforts may encounter significant support from physicians and may benefit from including physician leaders in their efforts.

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Carbon footprint of robotically‐assisted laparoscopy, laparoscopy and laparotomy: a comparison

Abstract: Our results provide clinicians, administrators and policy-makers with knowledge of the environmental impact of their decisions to facilitate adoption of sustainable practices.

Cited by 79 publications

References 19 publications

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

The Carbon Footprint of Surgical Operations

Attitude of US obstetricians and gynaecologists to global warming and medical waste

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