Carbon footprint of robotically‐assisted laparoscopy, laparoscopy and laparotomy: a comparison
Abstract
Background To date there have been no comprehensive, comparative assessments of the environmental impact of surgical modalities. Our study seeks to quantify and compare the total greenhouse gas emissions, or 'carbon footprint', attributable to three surgical modalities. Methods A review of 150 staging procedures, employing laparotomy (LAP), conventional laparoscopy (LSC) or robotically-assisted laparoscopy (RA-LSC), was performed. The solid waste generated (kg) and energy consumed (kWh) during each case were quantified and converted into their equivalent mass of carbon dioxide (kg CO(2) e) release into the environment. The carbon footprint is the sum of the waste production and energy consumption during each surgery (kg CO(2) e). Results The total carbon footprint of a RA-LSC procedure is 40.3 kg CO(2) e/patient (p Conclusions Our results provide clinicians, administrators and policy-makers with knowledge of the environmental impact of their decisions to facilitate adoption of sustainable practices.
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A top-down EEIO was used exclusively by one included study but was referred to as a carbon footprint.
“A 'top-down' EEIO was used exclusively by one study (35) but was referred to as a 'carbon footprint'.”
From The Carbon Footprint of Surgical Operations (2020) · cites this paper as [35]
Three included studies exclusively used bottom-up process-based approaches; one described their method as a carbon footprint, one as a multi-component analysis/carbon footprint, and one conducted full LCA.
“Three studies exclusively used 'bottom-up' process-based approaches, of which one simply described their method as a 'carbon footprint',(35) one described it as a 'multi-component analysis/carbon footprint', (26) and the other conducted full LCA.(31)”
From The Carbon Footprint of Surgical Operations (2020) · cites this paper as [35]
The most carbon intensive approach to gynaecological surgery was robotic, followed by laparoscopic, followed by laparotomy (and trans-vaginal within the former study).
“(35) found that the most carbon intensive approach to gynaecological surgery was robotic, followed by the laparoscopic approach, followed by laparotomy (followed by trans-vaginal approach within the former study).”
From The Carbon Footprint of Surgical Operations (2020) · cites this paper as [35]
Three studies found electricity to be the largest source of GHG emissions, accounting for 63-78% of the carbon footprint of whole operations.
“Three studies (26,31,35) found electricity to be the largest source of GHG emissions, accounting for 63-78% of the carbon footprint of whole operations”
From The Carbon Footprint of Surgical Operations (2020) · cites this paper as [35]
Three included studies used primary process activity data only, one used secondary financial activity data only, and all others used a mixture of data types.
“Three studies used primary process activity data only, (26,31,35) one used secondary financial activity data only (32) and all others used a mixture of data types (Supplementary Table 3).(7,27,33,34)”
From The Carbon Footprint of Surgical Operations (2020) · cites this paper as [35]
The carbon footprint of different operations will vary, and are likely dependent upon the invasiveness of the procedure, patient factors, and the surgical team, which each impact operative time and consumables used.
“The carbon footprint of different operations will vary, and are likely to be dependent upon the invasiveness of the procedure, patient factors, and the surgical team, which will each impact on operative time and consumables used.(35)”
From The Carbon Footprint of Surgical Operations (2020) · cites this paper as [35]
For a given process, the number of observations or data points collected was reported in two studies for all processes.
“For a given process, the number of observations or data points collected was reported in two studies for all processes, (32,35)”
From The Carbon Footprint of Surgical Operations (2020) · cites this paper as [35]
Parameter uncertainty was calculated by two studies.
“Parameter uncertainty (uncertainty relating to the data collection or emissions factors) was calculated by two studies.(7,35)”
From The Carbon Footprint of Surgical Operations (2020) · cites this paper as [35]
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Recent progress on carbon footprint assessment of healthcare services
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Uncovering the Evidence for Sustainability in Urology: A Scoping Review
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Digitalisierung und Klimaschutz: Wirkung des Megatrends auf Nachhaltigkeit im Gesundheitswesen
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Umweltauswirkungen des Gesundheitssektors
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Environmental sustainability in gynecologic oncology
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Sustainable Operating Rooms: A Comprehensive Framework for Environmental Impact Analysis
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Decision-making Factors in Surgical Techniques and Attitudes Towards Environmental Sustainability
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The Carbon-Neutral Operating Theatre
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The future of sustainable robotics for use in minimally invasive surgery
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- Authors
- Woods, D. L., McAndrew, T., Nevadunsky, N., Hou, J. Y., Goldberg, G., Yi‐Shin Kuo, D., & Isani, S.
- Affiliations
- Emory University (US)
- Albert Einstein College of Medicine (US)
- Albert Einstein College of Medicine Division of Gynecologic Oncology, Montefiore Medical Center, Department of Obstetrics and Gynecology and Women's Health Bronx NY USA
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Woods, Demetrius L.
- Venue
- The International Journal of Medical Robotics and Computer Assisted Surgery
- Publisher
- Wiley
- Published
- 2015-02-22
- Volume
- 11
- Issue
- 4
- Pages
- 406-412
- ISSN
- 1478-5951 (ISSN-L)
- 1478-596X
- OpenAlex
- W1511744004
- Cited by
- 129
- References
- 28
- Citations by year
- 2026: 11 · 2025: 29 · 2024: 29 · 2023: 15 · 2022: 19 · 2021: 7 · 2020: 7 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 2
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Medical Robotics and Computer Assisted Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Environmental Science › Environmental Engineering › Environmental Impact and Sustainability
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Physical Sciences › Engineering › Electrical and Electronic Engineering › Green IT and Sustainability
- Keywords
- carbon footprint, greenhouse gas emissions, conventional laparoscopy, laparotomy, surgical waste, environmental impact of surgery
- MeSH terms
- Carbon Dioxide, Laparotomy, Laparoscopes, Carbon Footprint, Robotic Surgical Procedures
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