1
|
Pradere B, Mallet R, de La Taille A, Bladou F, Prunet D, Beurrier S, Bardet F, Game X, Fournier G, Lechevallier E, Meria P, Matillon X, Polguer T, Abid N, De Graeve B, Kassab D, Mejean A, Misrai V, Pinar U. Climate-smart Actions in the Operating Theatre for Improving Sustainability Practices: A Systematic Review. Eur Urol 2023; 83:331-342. [PMID: 35151515 DOI: 10.1016/j.eururo.2022.01.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/02/2022] [Accepted: 01/11/2022] [Indexed: 11/15/2022]
Abstract
CONTEXT Surgical activity contributes to global warming though the production of greenhouse gases and consumption of resources. To date, no clinical practice guidelines have been made to promote and implement climate-smart actions. OBJECTIVE To perform a systematic review of the available actions that could limit CO2 emission in the operating room (OR) and their potential benefits upon the environment, whilst preserving quality of care. EVIDENCE ACQUISITION MEDLINE and Cochrane databases were searched from January 1, 1990 to April 2021. We included studies assessing carbon footprint (CF) in the OR and articles detailing actions that limit or reduce CF. EVIDENCE SYNTHESIS Thirty-eight studies met the inclusion criteria. We identified six core climate-smart actions: (1) waste reduction by segregation; (2) waste reduction by recycling, reuse, and reprocessing; (3) sterilisation; (4) anaesthesia gas management; and (5) improvement of energy use. Quantitative analysis regarding the CF was not possible due to the lack of homogeneous data. For climate-smart actions, the analysis was limited by discrepancies in study scope and in the methodology of CO2 emission calculation. Improvement of education and awareness was found to have an important impact on waste segregation and reduction. Waste management is the area where health care workers could have the strongest impact, whereas the main field to reduce CF in the OR was found to be energy consumption. CONCLUSIONS This review provides arguments for many climate-smart actions that could be implemented in our daily practice. Improving awareness and education are important to act collectively in a sustainable way. Further studies are mandatory to assess the impact of these climate-smart actions in the OR. PATIENT SUMMARY We performed a systematic review of the available scientific literature to reference all the climate-smart actions proposed to improve the sustainability of surgical activities. Waste segregation, waste reduction and recycling, reuse and reprocessing, sterilisation, anaesthesia gas changes, and improvement of energy use in the operating room were found to be the main areas of research. There is still a long way to go to homogenise and improve the quality of our climate-smart actions.
Collapse
Affiliation(s)
- Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.
| | - Richard Mallet
- Department of Urology, Hopital Privé Francheville, Périgueux, France
| | - Alexandre de La Taille
- Department of Urology, University Hospital Henri Mondor, AP-HP, UPEC, Créteil Cédex, France
| | - Franck Bladou
- Department of Urology, Pellegrin University Hospital, Bordeaux, France
| | - Denis Prunet
- Department of Urology, Clinique Urologie Royan, Royan, France
| | - Sarah Beurrier
- Department of Urology, Hopital Cochin AP-HP, Paris, France
| | | | - Xavier Game
- Department of Urology, Centre Hospitalier Universitaire de Rangueil, Université Toulouse III, Toulouse, France
| | - Georges Fournier
- Department of Urology, Hôpital de la Cavale Blanche, Université de Brest, Brest, France
| | - Eric Lechevallier
- Department of Urology, Aix-Marseille Université, CHU La Conception, AP-HM, Marseille, France
| | - Paul Meria
- Department of Urology, Hopital Saint Louis, APH-HP, Paris, France
| | - Xavier Matillon
- Department of Urology, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Thomas Polguer
- Department of Urology, CH Romans-sur-Isère, Hopitaux Drome nord, Romans-sur-Isère, France
| | - Nadia Abid
- Department of Urology, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | | | - Arnaud Mejean
- Department of Urology, Hôpital Européen Georges Pompidou, AP-HP Centre, Université de Paris, Paris, France
| | - Vincent Misrai
- Department of Urology, Clinique Pasteur, Toulouse, France
| | - Ugo Pinar
- Department of Urology, Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Pitie-Salpetriere Hospital, Paris, France
| | | |
Collapse
|
4
|
Psaltikidis EM, Graziano KU, Frezatti F. [Cost analysis of reprocessing disposable forceps used in video-assisted surgery]. Rev Lat Am Enfermagem 2006; 14:593-600. [PMID: 16967167 DOI: 10.1590/s0104-11692006000400018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2005] [Accepted: 06/14/2006] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the reprocessing costs of disposable forceps used in video-assisted surgery. The frequent reuse of these instruments is justified by their high cost. However, few studies have been carried out on this topic. The multiple case study method was applied in three hospitals in the State of São Paulo, using the observation and document analysis techniques. In case number one, the processing cost was R dollars 9.37, R dollars 6.59 for case number two and R dollars 3.31 for case number three. The low cost observed should be analyzed with caution, since it was observed that quality-control plays a role in the final cost. When the quality-control measures are adopted, the reprocessing costs jumped to R dollars 185.19 for case number one, R dollars 595.82 for case number two and to R dollars 363.10 for case number three.
Collapse
|
6
|
Abstract
This is the third in a series of three articles about reprocessing medical devices labeled as "single use" by the manufacturer. The goal of reprocessing single-use devices (SUDs) is to save money and decrease environmental pollution. Reprocessing can be performed on SUDs that have been used on other patients or opened but not used. This article discusses the roles of the involved regulatory agencies and organizations guiding the process. The first article in the series, published in the May 2002 issue of the AORN Journal, discusses the ethical component of reusing SUDs. The second article, published in the June 2002 issue of the Journal, discusses the procedures for reprocessing (e.g., cleaning, inspecting, sterilizing, tracking, testing, validating) and establishing a reuse program.
Collapse
Affiliation(s)
- Debra Dunn
- St. Joseph's Wayne Hospital, Wayne, NJ, USA
| |
Collapse
|