ArticleJournal of the Royal Society of Medicine2023
The carbon footprint of products used in five common surgical operations: identifying contributing products and processes.
Article in Journal of the Royal Society of Medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07657039 (USE LESS, a Comparative Cohort Study of Climate Change Impact From Orthopedic Surgery.), which is not on this map. Cited by 52 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
USE LESS, a Comparative Cohort Study of Climate Change Impact From Orthopedic Surgery.
Who cites it
52 citing papers in PubMed, 5 syntheses or guidelines pooled it, 107 citations in OpenAlex.
- Environmental impact of laparoscopic and robotic colorectal surgery: a systematic review.Journal of robotic surgery · 2026Pooled it
- Quantifying the environmental footprint of primary hip and knee arthroplasty: a systematic review and pooled-analysis of waste generation and carbon emissions.International orthopaedics · 2026Pooled it
- Increasing the environmental sustainability of operating rooms in Canada: an evidence-informed guideline for policy.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Guideline
- Pooled it
- Decarbonizing surgical care: a qualitative systematic review guided by the Congruence Model.BMC health services research · 2024Pooled it
- Article
- Carbon footprint reduction in shoulder surgery by the rationalisation of single-use convenience packs.Shoulder & elbow · 2026Article
- Carbon footprint of disposable, hybrid, and reusable trocars in diverse hospital settings: a life cycle assessment.Surgical endoscopy · 2026Article
- The rise of green orthopaedics: a bibliometric mapping and thematic evaluation of the global research landscape.International orthopaedics · 2026Article
- Theatre-Based Carbon Footprint of Five Common Orthopaedic Trauma Procedures: A Single-Centre Comparative Analysis.Cureus · 2026Article
- Neurosurgical Theatres' Carbon Net Efficiency: A Service Improvement Project Conducted via the Oxford Cranioplasty Pathway.Healthcare (Basel, Switzerland) · 2026Article
- Article
- WaSTE: a multicentre audit of waste segregation practices in elective knee and hip arthroplasty.Bone & joint open · 2026Article
- Article
- [Glaucoma: ecological comparison of disposable and reusable measuring bodies for applanation tonometry according to Goldmann].Die Ophthalmologie · 2026Article
- Surgical tray optimization: a prospective and survey-based evaluation of environmental and economic outcomes.Surgical endoscopy · 2026Article
- Article
- Evaluating the impact of reusable gowns on postoperative infection rates in hand surgery.Surgery in practice and science · 2026Article
- Contribution of hospitals and clinical services to global warming: a scoping systematic review.Frontiers in public health · 2026Article
- Sustainable and accessible hemodialysis: life cycle assessment on central acid delivery system.BMC nephrology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMitigating carbon footprint of products used in resource-intensive areas such as surgical operating rooms will be important in achieving net zero carbon healthcare. The aim of this study was to evaluate the carbon footprint of products used within five common operations, and to identify the biggest contributors (hotspots).
designA predominantly process-based carbon footprint analysis was conducted for products used in the five highest volume surgical operations performed in the National Health System in England.
settingThe carbon footprint inventory was based on direct observation of 6-10 operations/type, conducted across three sites within one NHS Foundation Trust in England.
participantsPatients undergoing primary elective carpal tunnel decompression, inguinal hernia repair, knee arthroplasty, laparoscopic cholecystectomy, tonsillectomy (March 2019 - January 2020).
main outcome measuresWe determined the carbon footprint of the products used in each of the five operations, alongside greatest contributors through analysis of individual products and of underpinning processes.
resultsThe mean average carbon footprint of products used for carpal tunnel decompression was 12.0 kg CO
conclusionsChange in practice and policy should be targeted towards those products making greatest contribution, and should include reducing single-use items and switching to reusables, alongside optimising processes for decontamination and waste disposal, modelled to reduce carbon footprint of these operations by 23%-42%.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.