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Pioche M, Pohl H, Cunha Neves JA, Laporte A, Mochet M, Rivory J, Grau R, Jacques J, Grinberg D, Boube M, Baddeley R, Cottinet PJ, Schaefer M, Rodríguez de Santiago E, Berger A. Environmental impact of single-use versus reusable gastroscopes. Gut 2024:gutjnl-2024-332293. [PMID: 39122363 DOI: 10.1136/gutjnl-2024-332293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION The environmental impact of endoscopy is a topic of growing interest. This study aimed to compare the carbon footprint of performing an esogastroduodenoscopy (EGD) with a reusable (RU) or with a single-use (SU) disposable gastroscope. METHODS SU (Ambu aScope Gastro) and RU gastroscopes (Olympus, H190) were evaluated using life cycle assessment methodology (ISO 14040) including the manufacture, distribution, usage, reprocessing and disposal of the endoscope. Data were obtained from Edouard Herriot Hospital (Lyon, France) from April 2023 to February 2024. Primary outcome was the carbon footprint (measured in Kg CO2 equivalent) for both gastroscopes per examination. Secondary outcomes included other environmental impacts. A sensitivity analysis was performed to examine the impact of varying scenarios. RESULTS Carbon footprint of SU and RU gastroscopes were 10.9 kg CO2 eq and 4.7 kg CO2 eq, respectively. The difference in carbon footprint equals one conventional car drive of 28 km or 6 days of CO2 emission of an average European household. Based on environmentally-extended input-output life cycle assessment, the estimated per-use carbon footprint of the endoscope stack and washer was 0.18 kg CO2 eq in SU strategy versus 0.56 kg CO2 eq in RU strategy. According to secondary outcomes, fossil eq depletion was 130 MJ (SU) and 60.9 MJ (RU) and water depletion for 6.2 m3 (SU) and 9.5 m3 (RU), respectively. CONCLUSION For one examination, SU gastroscope have a 2.5 times higher carbon footprint than RU ones. These data will help with the logistics and planning of an endoscopic service in relation to other economic and environmental factors.
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Affiliation(s)
| | - Heiko Pohl
- Gastroenterology and Hepatology, White River Junction VA Medical Center, White River Junction, Vermont, USA
| | | | | | - Mikael Mochet
- Endoscopy division, Hospices Civils de Lyon, Lyon, France
| | - Jérôme Rivory
- Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon, France
- Gastroenterology and Endoscopy, Hopital Croix Rousse, Lyon, France
| | | | - Jérémie Jacques
- Gastroenterology, Hopital Dupuytren, Limoges, France
- UMR 7252, CNRS XLIM, Limoges, France
| | - Daniel Grinberg
- Hospices Civils de Lyon, Lyon, France
- Material Analysis Laboratory, Villeurbanne, France
| | | | - Robin Baddeley
- St Mark's the National Bowel Hospital and Academic Institute, London, UK
- Institute for Therapeutic Endoscopy, King's Health Partners, London, UK
| | | | - Marion Schaefer
- Department of Hepatogastroentrology, Nancy Regional University Hospital Center, Nancy, France
| | | | - Arthur Berger
- Department of Gastroenterology and Hepatology, Bordeaux university hospital, Bordeaux, France
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Pioche M, Cunha Neves JA, Pohl H, Lê MQ, Grau R, Dray X, Yzet C, Mochet M, Jacques J, Wallenhorst T, Rivory J, Siret N, Peillet AL, Chevaux JB, Mion F, Chaput U, Jacob P, Grinberg D, Saurin JC, Baddeley R, Rodriguez de Santiago E, Cottinet PJ. The environmental impact of small-bowel capsule endoscopy. Endoscopy 2024. [PMID: 38657660 DOI: 10.1055/a-2313-5142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The environmental impact of endoscopy, including small-bowel capsule endoscopy (SBCE), is a topic of growing attention and concern. This study aimed to evaluate the greenhouse gas (GHG) emissions (kgCO2) generated by an SBCE procedure. METHODS Life cycle assessment methodology (ISO 14040) was used to evaluate three brands of SBCE device and included emissions generated by patient travel, bowel preparation, capsule examination, and video recording. A survey of 87 physicians and 120 patients was conducted to obtain data on travel, activities undertaken during the procedure, and awareness of environmental impacts. RESULTS The capsule itself (4 g) accounted for < 6 % of the total product weight. Packaging (43-119 g) accounted for 9 %-97 % of total weight, and included deactivation magnets (5 g [4 %-6 %]) and paper instructions (11-50 g [up to 40 %]). A full SBCE procedure generated approximately 20 kgCO2, with 0.04 kgCO2 (0.2 %) attributable to the capsule itself and 18 kgCO2 (94.7 %) generated by patient travel. Capsule retrieval using a dedicated device would add 0.98 kgCO2 to the carbon footprint. Capsule deconstruction revealed materials (e. g. neodymium) that are prohibited from environmental disposal; 76 % of patients were not aware of the illegal nature of capsule disposal via wastewater, and 63 % would have been willing to retrieve it. The carbon impact of data storage and capsule reading was negligible. CONCLUSION The carbon footprint of SBCE is mainly determined by patient travel. The capsule device itself has a relatively low carbon footprint. Given that disposal of capsule components via wastewater is illegal, retrieval of the capsule is necessary but would likely be associated with an increase in device-related emissions.
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Affiliation(s)
- Mathieu Pioche
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Joao A Cunha Neves
- Department of Gastroenterology, Algarve University Hospital Centre, Portimão, Portugal
| | - Heiko Pohl
- Departments of Gastroenterology, VA Medical Center, White River Junction, Vermont; and Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Minh-Quyen Lê
- Material Analysis Laboratory, INSA Lyon, Villeurbanne, France
| | - Raphaelle Grau
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Xavier Dray
- Sorbonne University, Centre for Digestive Endoscopy, Hôpital Saint-Antoine, APHP, Paris, France
| | - Clara Yzet
- Endoscopy and Gastroenterology Unit, University Hospital, Amiens, France
| | - Mikael Mochet
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Timothée Wallenhorst
- Gastroenterology and Endoscopy Unit, University Hospital Pontchaillou, Rennes, France
| | - Jérôme Rivory
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Nadège Siret
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Anne-Laure Peillet
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - François Mion
- Digestive Physiology Department, Hospices Civils de Lyon, Lyon, France
| | - Ulriikka Chaput
- Sorbonne University, Centre for Digestive Endoscopy, Hôpital Saint-Antoine, APHP, Paris, France
| | - Philippe Jacob
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Gastroenterology and Endoscopy Unit, Nimes Private Clinic, Nimes, France
| | - Daniel Grinberg
- Material Analysis Laboratory, INSA Lyon, Villeurbanne, France
- Cardiac Surgery, Cardiologic Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jean-Christophe Saurin
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Robin Baddeley
- Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute; King's Health Partners Institute for Therapeutic Endoscopy, King's College Hospital; and Imperial College London, London, UK
| | - Enrique Rodriguez de Santiago
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
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Laugié M, Rivory J, Lupu A, Rostain F, Lafeuille P, Yzet C, Pioche M. Three different strategies to overcome dilation failures of the bougie cap for upper gastrointestinal refractory strictures. Endoscopy 2023; 55:E723-E724. [PMID: 37187209 PMCID: PMC10185408 DOI: 10.1055/a-2081-9329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- Marie Laugié
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jérôme Rivory
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Alexandru Lupu
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Florian Rostain
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Pierre Lafeuille
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Clara Yzet
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
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Lafeuille P, Yzet C, Bonniaud P, Rostain F, Ponchon T, Rivory J, Pioche M. Use of a bougie-shaped cap for dilation with direct visual control for an esophageal stricture induced by radiation therapy. Endoscopy 2022; 55:E18-E19. [PMID: 36113487 PMCID: PMC9812673 DOI: 10.1055/a-1929-9317] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Pierre Lafeuille
- Department of Endoscopy and Hepatogastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Clara Yzet
- Department of Endoscopy and Hepatogastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Paul Bonniaud
- Department of Endoscopy and Hepatogastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Florian Rostain
- Department of Endoscopy and Hepatogastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Thierry Ponchon
- Department of Endoscopy and Hepatogastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Jérôme Rivory
- Department of Endoscopy and Hepatogastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Mathieu Pioche
- Department of Endoscopy and Hepatogastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
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