Carbon footprinting and sustainability impact assessment in urological surgical practice: A systematic review

TY - JOUR

T1 - Carbon footprinting and sustainability impact assessment in urological surgical practice

T2 - A systematic review

AU - Wani, Mudassir

AU - Madaan, Sanjeev

AU - Brown, Gareth

AU - Steggall, Martin

AU - Nabi, Ghulam

N1 - Publisher Copyright: © The Author(s) 2024.

PY - 2024/11/6

Y1 - 2024/11/6

N2 - Objectives: To systematically synthesize existing reported literature calculating the carbon footprint (CFP) of urological surgical practice and identify opportunities for improving the environmental impact of urology surgical practice. Methods: A systematic review was performed following PRISMA guidelines. The Cochrane, Embase, Ovid MEDLINE, and PubMed were searched between 1971 and 2023, with inclusion and exclusion criteria. The outcome measures were mapped across the included studies including assessment of risk of bias. Results: A total of 345 studies with titles were identified from an initial search, however only 5 were included. Three studies compared singleuse with reusable cystoscopes concluded that single-use cystoscopes are non-inferior to reusable cystoscopes environmentally due to the carbon footprint associated with decontamination and repackaging. Similarly, in a single study, the CFP of single-use and reusable ureteroscopes is comparable. Lastly, a single study concluded that robotics-assisted surgery in prostate cancer may be a better option than other approaches in terms of environmental sustainability. Conclusions: In conclusion, although minimally invasive (including robotic approaches) and endoscopic surgeries offer significant opportunities to improve healthcare we do need to consider the environmental impact. However, there is a paucity of good-quality literature to guide urological surgical practice to reduce the CFP and improve sustainability.

AB - Objectives: To systematically synthesize existing reported literature calculating the carbon footprint (CFP) of urological surgical practice and identify opportunities for improving the environmental impact of urology surgical practice. Methods: A systematic review was performed following PRISMA guidelines. The Cochrane, Embase, Ovid MEDLINE, and PubMed were searched between 1971 and 2023, with inclusion and exclusion criteria. The outcome measures were mapped across the included studies including assessment of risk of bias. Results: A total of 345 studies with titles were identified from an initial search, however only 5 were included. Three studies compared singleuse with reusable cystoscopes concluded that single-use cystoscopes are non-inferior to reusable cystoscopes environmentally due to the carbon footprint associated with decontamination and repackaging. Similarly, in a single study, the CFP of single-use and reusable ureteroscopes is comparable. Lastly, a single study concluded that robotics-assisted surgery in prostate cancer may be a better option than other approaches in terms of environmental sustainability. Conclusions: In conclusion, although minimally invasive (including robotic approaches) and endoscopic surgeries offer significant opportunities to improve healthcare we do need to consider the environmental impact. However, there is a paucity of good-quality literature to guide urological surgical practice to reduce the CFP and improve sustainability.

KW - Carbon footprinting

KW - sustainability

KW - urological surgery

UR - https://www.scopus.com/pages/publications/85208602796

U2 - 10.1177/00369330241280206

DO - 10.1177/00369330241280206

M3 - Review article

C2 - 39501965

AN - SCOPUS:85208602796

SN - 0036-9330

VL - 69

SP - 88

EP - 98

JO - Scottish Medical Journal

JF - Scottish Medical Journal

IS - 3

ER -