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Trieu E, Ramirez-Caban LC, Shockley ME. Review of sustainable practices for the gynecology operating room. Curr Opin Obstet Gynecol 2024; 36:324-329. [PMID: 38837721 DOI: 10.1097/gco.0000000000000965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE OF REVIEW Climate change has immediate impacts on women's health. Hospitals and operating rooms are large contributors to greenhouse gas (GHG) emissions and waste. This article will review current green initiatives designed to minimize environmental impact in the operating room and highlight areas for future improvement. RECENT FINDINGS From a materials perspective, reusable goods result in less GHG emissions while being just as efficacious, well tolerated, and easy to use. Materials should be opened judiciously, only as necessary. Processing regulated medical waste produces greater GHG emissions, so waste should be properly sorted, and items which are not biohazard waste should be processed separately. Choosing appropriate anesthesia and utilizing an 'off' setting, in which operating rooms are shut down when not in use, can also drastically decrease the environmental impact of surgery. Further research is needed to determine effective implementation in hospitals. SUMMARY This article summarizes current attempts to make operating rooms more sustainable. Many practices result in a decreased carbon footprint and cost savings without adversely affecting patient outcomes. Gynecologic surgeons and the hospitals in which they practice need to focus on implementing these changes in a timely fashion.
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Affiliation(s)
- Elissa Trieu
- Division of Gynecologic Specialties, Department of Obstetrics and Gynecology, Emory University, Atlanta, Georgia, USA
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Lawaczeck L, Rudolph J, Norz V, Tsaur I, Rausch S. The role of planetary health in urologic oncology. Expert Rev Anticancer Ther 2024; 24:513-523. [PMID: 38709157 DOI: 10.1080/14737140.2024.2350631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Climate change and global warming are an omnipresent topic in our daily lives. Planetary health and oncology represent two critical domains within the broader spectrum of healthcare, each addressing distinct yet interconnected aspects of human well-being. We are encouraged to do our part in saving our planet. This should include the decisions we make in our professional life, especially in uro-oncology, as the healthcare sector significantly contributes to environmental pollution. AREAS COVERED There are many aspects that can be addressed in the healthcare sector in general, as there are structural problems in terms of energy consumption, water waste, therapeutic techniques, transportation and drug manufacturing, as well as in uro-oncology specific areas. For example, the use of different surgical techniques, forms of anesthesia and the use of disposable or reusable instruments, each has a different impact on our environment. The literature search was carried out using PubMed, a medical database. EXPERT OPINION We are used to making decisions based on the best outcome for patients without considering the impact that each decision can have on the environment. In the present article, we outline options and choices for a more climate-friendly approach in urologic oncology.
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Affiliation(s)
- Laura Lawaczeck
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Julia Rudolph
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Valentina Norz
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Igor Tsaur
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Steffen Rausch
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
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Cannon J, Tailor H, Douglas C. Carbon footprint of tonsillectomy. Surgeon 2024:S1479-666X(24)00059-3. [PMID: 38918114 DOI: 10.1016/j.surge.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/31/2024] [Accepted: 06/10/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND AND PURPOSE Healthcare is responsible for 5.4% of greenhouse gas emissions in the UK. Emissions in surgery is a relatively unexplored area; in particular, this hasn't yet been looked at as a whole in ENT in the UK. The purpose of the study was to quantify the amount of greenhouse gas (GHG) emission from a tonsillectomy and assess the proportion of each source's contribution. METHODS Operational data from tonsillectomies performed at a large university teaching hospital in the UK were gathered and converted to global warming potential using established conversion factors and data from existing healthcare-focused carbon footprint studies. The domains considered were waste, pharmaceuticals, surgical instrument decontamination, transportation, consumables use and utilities. This study used a process-based carbon footprint approach based on the "Greenhouse Gas Protocol: Product Life Cycle Accounting and Reporting Standard". MAIN FINDINGS The carbon footprint of a typical case was 41 kgCO2e which is equivalent to driving a car for approximately 150 miles. Consumables were responsible for 17% of this; 14% came from transport, 5.4% from decontamination, 4.8% from pharmaceuticals and 4% from waste. However, the largest GHG was from utilities, of which heating, ventilation and air conditioning was the overwhelming contributor. CONCLUSIONS While the largest sources of GHG emissions require hospital-wide initiatives, there are aspects of consumables and waste streams we can improve on in ENT surgery. These include the use of disposable vs reusable instruments as well as increased availability and use of recycling waste streams in theatres. Additionally, this study provides a template that can be applied to other ENT procedures.
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Affiliation(s)
- Joseph Cannon
- University of Glasgow Medical School, Wolfson Medical School Building, University Ave, Glasgow, Scotland.
| | - Hiteshkumar Tailor
- University of Glasgow Medical School, Wolfson Medical School Building, University Ave, Glasgow, Scotland; Department of Otolaryngology - Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland
| | - Catriona Douglas
- University of Glasgow Medical School, Wolfson Medical School Building, University Ave, Glasgow, Scotland; Department of Otolaryngology - Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland
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Cameron R, Haymes A, Pepper C, Possamai V, Blaney S, Morrison G, Jonas N, Jablenska L, Ferguson L, Lilly I, Sharma S, Amin N, Tweedie DJ. Coblation intracapsular tonsillectomy in a paediatric tertiary centre: Revision surgery rates over a nine-year period. Int J Pediatr Otorhinolaryngol 2024; 181:111942. [PMID: 38723424 DOI: 10.1016/j.ijporl.2024.111942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Coblation intracapsular tonsillectomy (ICT) is increasingly being used in the paediatric population because of the rapid recovery and low rates of complications associated with it. There is, however, a risk of symptomatic regrowth with this technique. The objective of our study is to establish the rate of, and risks for, revision surgery over time in a major tertiary referral centre with a large cohort of paediatric Coblation ICT cases. METHODS A retrospective review of all children (0-19 years) undergoing Coblation ICT from April 2013 to June 2022 was undertaken, using electronic databases and clinical records. Post-operative follow up was reviewed and revision cases were subsequently identified and examined. Statistical analysis was performed using a Chi-Squared test. RESULTS 4111 patients underwent Coblation ICT during the studied period, with or without concomitant adenoidectomy. Of these, 135 (3.3 %) required revision tonsil surgery, primarily for recurrence of initial symptoms; two patients required two consecutive revision procedures (137 revision procedures in total). Eight-eight (n = 88) (64 %) of these were revised with a repeat Coblation ICT procedure and 49 (36 %) with bipolar diathermy extracapsular tonsillectomy (ECT) of remnant tonsil tissue. The revision rates after Coblation ICT declined steeply on a year-on-year basis since the commencement of this technique (from 10.6 % early on, to 0.3 % at the end of the study period P<0.001). A significantly higher revision rate was noted in children below the age of two at the time of primary surgery, compared to those older than two years of age (P<0.001). CONCLUSIONS This study demonstrates real-world departmental revision rates over a nine-year period from the technique's commencement of use. With Coblation ICT, symptomatic re-growth occurs rarely, but may be clinically significant, with higher rates of recurrent symptoms seen in children under two years of age at the time of primary surgery. The revision rate apparently drops over time in parallel with overall experience of surgeons and formalised training.
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Affiliation(s)
- Rujuta Cameron
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
| | - Adam Haymes
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Christopher Pepper
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Victoria Possamai
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Sean Blaney
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Gavin Morrison
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Nicolaas Jonas
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Liliana Jablenska
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Louisa Ferguson
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Ian Lilly
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Shradha Sharma
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Nikul Amin
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Daniel J Tweedie
- Department of Paediatric ENT, Evelina London Children's Hospital, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK
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Spinos D, Doshi J, Garas G. Delivering a net zero National Health Service: where does otorhinolaryngology - head and neck surgery stand? J Laryngol Otol 2024; 138:373-380. [PMID: 37795753 DOI: 10.1017/s0022215123001780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE The National Health Service (NHS) recognised the risk to public health brought by climate change by launching the Greener NHS National Programme in 2020. These organisational changes aim to attain net zero direct carbon emissions. This article reviews the literature on initiatives aimed at mitigating the environmental impact of ENT practice. METHOD Systematic review of the literature using scientific, healthcare and general interest (public domain) databases. RESULTS The initiatives reviewed can be broken down into strategies for mitigating the carbon footprint of long patient stay, use of operative theatres and healthcare travel. The carbon footprint of in-patient stay can be mitigated by a shift towards day-case surgery. The ENT community is currently focused on the reduction of theatre waste and the use of disposable instruments. Furthermore, supply chains and healthcare delivery models are being redesigned to reduce travel. CONCLUSION Future areas of development include designing waterless theatre scrubs, waste-trapping technologies for anaesthetic gases and a continuing investment in virtual healthcare.
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Affiliation(s)
- Dimitrios Spinos
- Department of Otorhinolaryngology - Head and Neck Surgery, Gloucestershire Hospitals NHS Foundation Trust, Department of Otolaryngology, Gloucester, UK
| | - Jayesh Doshi
- Department of Otorhinolaryngology - Head and Neck Surgery, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - George Garas
- Head & Neck Surgical Oncology Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Surgical Innovation Centre, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
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Spil NA, van Nieuwenhuizen KE, Rowe R, Thornton JG, Murphy E, Verheijen E, Shelton CL, Heazell AEP. The carbon footprint of different modes of birth in the UK and the Netherlands: An exploratory study using life cycle assessment. BJOG 2024; 131:568-578. [PMID: 38272843 DOI: 10.1111/1471-0528.17771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE To compare the carbon footprint of caesarean and vaginal birth. DESIGN Life cycle assessment (LCA). SETTING Tertiary maternity units and home births in the UK and the Netherlands. POPULATION Birthing women. METHODS A cradle-to-grave LCA using openLCA software to model the carbon footprint of different modes of delivery in the UK and the Netherlands. MAIN OUTCOME MEASURES 'Carbon footprint' (in kgCO2 equivalents [kgCO2 e]). RESULTS Excluding analgesia, the carbon footprint of a caesarean birth in the UK was 31.21 kgCO2 e, compared with 12.47 kgCO2 e for vaginal birth in hospital and 7.63 kgCO2 e at home. In the Netherlands the carbon footprint of a caesarean was higher (32.96 kgCO2 e), but lower for vaginal birth in hospital and home (10.74 and 6.27 kgCO2 e, respectively). Emissions associated with analgesia for vaginal birth ranged from 0.08 kgCO2 e (with opioid analgesia) to 237.33 kgCO2 e (nitrous oxide with oxygen). Differences in analgesia use resulted in a lower average carbon footprint for vaginal birth in the Netherlands than the UK (11.64 versus 193.26 kgCO2 e). CONCLUSION The carbon footprint of a caesarean is higher than for a vaginal birth if analgesia is excluded, but this is very sensitive to the analgesia used; use of nitrous oxide with oxygen multiplies the carbon footprint of vaginal birth 25-fold. Alternative methods of pain relief or nitrous oxide destruction systems would lead to a substantial improvement in carbon footprint. Although clinical need and maternal choice are paramount, protocols should consider the environmental impact of different choices.
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Affiliation(s)
- Nienke A Spil
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- University of Groningen, Groningen, The Netherlands
| | | | - Rachel Rowe
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Elizabeth Murphy
- Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Evelyn Verheijen
- Department of Gynaecology, Saxenburgh Medisch Centrum, Hardenberg, The Netherlands
| | - Clifford L Shelton
- Department of Anaesthesia, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Alexander E P Heazell
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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Khanji MY, Patel R, Ricci F. Going green in cardiology. Eur Heart J 2024; 45:411-412. [PMID: 37889072 DOI: 10.1093/eurheartj/ehad703] [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: 10/28/2023] Open
Affiliation(s)
- Mohammed Y Khanji
- Barts Health NHS Trust, Newham University Hospital, Glen Road, Plaistow, London E13 8SL, UK
- Barts Health NHS Trust, Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University, Charter House Square, London EC1M 6BQ, UK
| | - Riyaz Patel
- Barts Health NHS Trust, Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy
- Department of Cardiology, SS. Annunziata Hospital, Chieti, Italy
- Department of Clinical Sciences, Lund University, Malmö, Sweden
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Parker EB, Bluman EM, Chiodo CP, Martin EA, Smith JT. Carbon Footprint of Minor Foot and Ankle Surgery: A Randomized Controlled Trial. FOOT & ANKLE ORTHOPAEDICS 2024; 9:24730114241238231. [PMID: 38510517 PMCID: PMC10952996 DOI: 10.1177/24730114241238231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Background Climate change poses a substantial threat to human health, and operating rooms (ORs) have an outsized environmental impact. The Program for Research in Sustainable Medicine (PRiSM) designed a protocol for minor foot and ankle surgery intended to reduce waste, streamline instrument trays, and minimize laundry. We conducted a randomized controlled trial to compare the carbon footprint of procedures performed using the PRiSM protocol vs a traditional protocol. Methods Forty adult patients undergoing foreign body removal, hammertoe correction, toe amputation, hardware removal, mass excision, or gastrocnemius recession were randomized to the PRiSM or our "Traditional" protocol. The PRiSM protocol used a smaller instrument tray, fewer drapes and towels, and minimal positioning blankets. No changes were made to surgical site preparation or operative techniques. Environmental impact was estimated using the carbon footprint, measured in kilograms of carbon dioxide equivalents (CO2e). Emissions associated with OR waste, instrument processing, and laundry were calculated. Results On average, PRiSM cases had a smaller carbon footprint than Traditional cases (17.3 kg CO2e [SD = 3.2] vs 20.6 kg CO2e [SD = 2.0], P < .001). Waste-associated emissions from PRiSM cases were reduced (16.0 kg CO2e [SD = 2.7] vs 18.4 kg CO2e [SD = 1.8], P = .002), as were modeled instrument processing-related emissions (0.34 vs 0.91 kg CO2e). One superficial surgical site infection occurred in each group. Conclusion We found a small but statistically significant reduction in the environmental impact of minor foot and ankle surgery when using the PRiSM vs Traditional protocol. The environmental impact of these cases was dominated by plastic waste-related emissions. Orthopaedic surgeons should think critically about what components of their surgical setup are truly necessary for patient care, as minor changes in product utilization can have significant impacts on waste and greenhouse gas emissions. Level of Evidence Level I, randomized controlled trial.
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Affiliation(s)
- Emily B. Parker
- Harvard Medical School, Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Eric M. Bluman
- Harvard Medical School, Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Christopher P. Chiodo
- Harvard Medical School, Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Elizabeth A. Martin
- Harvard Medical School, Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jeremy T. Smith
- Harvard Medical School, Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA
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Biswas S, McMenemy L, Sarkar V, MacArthur J, Snowdon E, Tetlow C, George KJ. Natural language processing for the automated detection of intra-operative elements in lumbar spine surgery. Front Surg 2023; 10:1271775. [PMID: 38164290 PMCID: PMC10757971 DOI: 10.3389/fsurg.2023.1271775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Background The aim of this study was to develop natural language processing (NLP) algorithms to conduct automated identification of incidental durotomy, wound drains, and the use of sutures or skin clips for wound closure, in free text operative notes of patients following lumbar surgery. Methods A single-centre retrospective case series analysis was conducted between January 2015 and June 2022, analysing operative notes of patients aged >18 years who underwent a primary lumbar discectomy and/or decompression at any lumbar level. Extreme gradient-boosting NLP algorithms were developed and assessed on five performance metrics: accuracy, area under receiver-operating curve (AUC), positive predictive value (PPV), specificity, and Brier score. Results A total of 942 patients were used in the training set and 235 patients, in the testing set. The average age of the cohort was 53.900 ± 16.153 years, with a female predominance of 616 patients (52.3%). The models achieved an aggregate accuracy of >91%, a specificity of >91%, a PPV of >84%, an AUC of >0.933, and a Brier score loss of ≤0.082. The decision curve analysis also revealed that these NLP algorithms possessed great clinical net benefit at all possible threshold probabilities. Global and local model interpretation analyses further highlighted relevant clinically useful features (words) important in classifying the presence of each entity appropriately. Conclusions These NLP algorithms can help monitor surgical performance and complications in an automated fashion by identifying and classifying the presence of various intra-operative elements in lumbar spine surgery.
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Affiliation(s)
- Sayan Biswas
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Lareyna McMenemy
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Ved Sarkar
- College of Letters and Sciences, University of California, Berkeley, CA, United States
| | - Joshua MacArthur
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Ella Snowdon
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Callum Tetlow
- Division of Data Science, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - K. Joshi George
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Manchester, United Kingdom
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Tsagkaris C, Saeed H, Laubscher L, Eleftheriades A, Stavros S, Drakaki E, Potiris A, Panagiotopoulos D, Sioutis D, Panagopoulos P, Zil-E-Ali A. Eco-Friendly and COVID-19 Friendly? Decreasing the Carbon Footprint of the Operating Room in the COVID-19 Era. Diseases 2023; 11:157. [PMID: 37987268 PMCID: PMC10660860 DOI: 10.3390/diseases11040157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
Surgery is one of the most energy-intensive branches of healthcare. Although the COVID-19 pandemic has reduced surgical volumes, infection control protocols have increased the ecological footprint of surgery owing to the extensive use of personal protective equipment, sanitation, testing and isolation resources. The burden of environmental diseases requiring surgical care, the international commitment towards environmental sustainability and the global efforts to return to the pre-pandemic surgical workflow call for action towards climate-friendly surgery. The authors have searched the peer-reviewed and gray literature for clinical studies, reports and guidelines related to the ecological footprint of surgical care and the available solutions and frameworks to reduce it. Numerous studies concede that surgery is associated with a high rate of energy utilization and waste generation that is comparable to major non-medical sources of pollution. Recommendations and research questions outlining environmentally sustainable models of surgical practices span from sanitation and air quality improvement systems to the allocation of non-recyclable consumables and energy-efficient surgical planning. The latter are particularly relevant to infection control protocols for COVID-19. Paving the way towards climate-friendly surgery is a worthy endeavor with a major potential to improve surgical practice and outcomes in the long term.
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Affiliation(s)
- Christos Tsagkaris
- Public Health and Policy Working Group, Stg European Student Think Tank, Postjeskade 29, 1058 DE Amsterdam, The Netherlands
| | - Hamayle Saeed
- Fatima Memorial Hospital College of Medicine & Dentistry, Lahore 54000, Pakistan
| | - Lily Laubscher
- Department of Health Sciences, Swiss Federal Institute of Technology Zurich, 8092 Zurich, Switzerland
| | - Anna Eleftheriades
- Faculty of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Sofoklis Stavros
- 3rd Department of Ob/Gyn, Attikon University Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece
| | - Eirini Drakaki
- 3rd Department of Ob/Gyn, Attikon University Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece
| | - Anastasios Potiris
- 3rd Department of Ob/Gyn, Attikon University Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece
| | - Dimitrios Panagiotopoulos
- 3rd Department of Ob/Gyn, Attikon University Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece
| | - Dimos Sioutis
- 3rd Department of Ob/Gyn, Attikon University Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece
| | - Periklis Panagopoulos
- 3rd Department of Ob/Gyn, Attikon University Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece
| | - Ahsan Zil-E-Ali
- Department of Heart and Vascular Institute, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
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Bernstein J. Not the Last Word: Climate Change Comes to Orthopaedics. Clin Orthop Relat Res 2023; 481:1878-1885. [PMID: 37678395 PMCID: PMC10499085 DOI: 10.1097/corr.0000000000002853] [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] [Received: 06/15/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Joseph Bernstein
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
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12
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Wedmore F. Reusable gowns and drapes in surgery could reduce carbon footprint, analysis shows. BMJ 2023; 381:853. [PMID: 37059466 DOI: 10.1136/bmj.p853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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