Green Surgery Report: Products used in Surgical Care

Section Highlights

Circular economy principles can be applied to reduce environmental impact of products, seeking to minimise waste material and energy at all stages of a product’s life cycle.

At the stage of product design, this may be facilitated through adopting the Design for the Environment framework, and applying the principles of Green Engineering, and Green Chemistry.

Core circular economy concepts which can be applied to healthcare products include refuse, reduce, reuse, recycle, renew (through repair or remanufacture) and recycle.

Average reductions in carbon footprint of 38-56% are achieved through switching from single-use to reusable equipment.

There are further opportunities to optimise environmental impact of reprocessing of reusable equipment; for example, through the preparation of instrument sets and by optimising the efficiency of washing and decontamination/sterilisation machines.

Section Recommendations

(1) Ensure that design and manufacture of products minimise the environmental impact throughout the product lifespan

(2) Ensure that modes of distribution with lowest environmental impact are chosen

(3) Reduce and rationalise equipment

(4) Switch from single-use to reusable equivalents where available

(5) Optimise reprocessing of reusable equipment

(6) Extend the lifespan of reusable products through repair and remanufacturing

(7) Optimise waste

Case Studies

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

_{*** Note: Outcomes data from case studies have not been verified and some financial and greenhouse gas emission figures are based on projections.}