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Green Surgery Report: Case Studies

Examples of real-world change efforts to reduce the carbon footprint of surgical care


The Green Surgery Report project team thanks all those who submitted case studies to this online repository, which illustrate examples of real-world change.

We request readers to note that outcomes data have not been verified and some financial and greenhouse gas emission figures are based on projections.

Section 2: Reducing need for Surgical Care

Identifying patients at high risk of fractures

Lean Pathway and Low Carbon Alternatives in Curette and Cautery Skin Surgery

Reducing prescription of Proton Pump Inhibitors

Section 3: Surgical Care Pathways

Carpal tunnel decompression in procedure room

Digital care pathway for total knee replacement

Early mobilisation in CICU

Eliminating unnecessary pre-operative blood test

Omitting routine Group and Save test

Reducing pathology sample transport

Reducing same day surgery cancellations

Shortened admission booklet

Virtual fracture clinic

Section 4: Operating Theatre Energy and Design

Elective theatres shutdown list

Improving laminar flow efficiency

Operating theatres shutdown list

Section 5: Anaesthesia

Cold sticks for spinal/epidural blocks

Decommissioning nitrous oxide manifold

Local anaesthesia for inguinal hernia repair

Section 6: Products used in Surgical Care

Improving sustainability in laparoscopic appendectomy

Introducing reusable surgical caps

Introducing reusable named surgical caps

Optimising reprocessing of reusable linens

Rationalisation of single-use convenience packs

Reducing non-sterile glove use

Reducing single-use instruments in laparoscopic appendectomy

Recycling surgical wrap

Reducing unnecessary cannulation (Royal Devon and Exeter)

Reducing unnecessary cannulation (Imperial)

Reducing unnecessary patient transfer sheets

Reducing use of harmonic scissors

Reducing use of PPE

Reducing waste from pulse lavage systems

Remanufacturing EP catheters (Barts)

Remanufacturing EP catheters (Leeds)

Remanufacturing EP catheters (Royal Devon)

Remanufacturing electrosurgical items

Section 7: Facilitating Implementation

Facilitating Inter-Departmental Sustainability Innovation

Ontario Surgical QI Network

Peer Education for Surgical Waste Management