SynthesisAnnals of the Royal College of Surgeons of England2023
The carbon footprint of surgical operations: a systematic review update.
Synthesis in Annals of the Royal College of Surgeons of England, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 4 syntheses or guidelines pooled 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
- Pooled it
- Comparison of low versus high (standard) intraabdominal pressure during laparoscopic colorectal surgery: systematic review and meta-analysis.International journal of colorectal disease · 2024Pooled it
- The carbon footprint of surgical operations: a systematic review update.Annals of the Royal College of Surgeons of England · 2023Pooled it
- Capture of isoflurane from anaesthetised dogs and cats following methadone, medetomidine and ketamine administration.The Veterinary record · 2026Article
- Surgical Site Infections in Major Lower Limb Amputation (SIMBA): international multicentre study.BJS open · 2026Observational
- Environmental Impact of a Vaginal Pelvic Organ Prolapse Procedure: A Life Cycle Assessment with Scenario Modelling of Mitigation Strategies.International urogynecology journal · 2026Article
- Review
- Integrating environmental considerations in HTA: The strategy of the Institut National d'Excellence en Santé et Services Sociaux (INESSS).International journal of technology assessment in health care · 2026Article
- Ditch the drapes: Non-sterile substitution in proctology, a population-based cost and carbon life cycle analysis with early implementation audit.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- Socioeconomic Impact, Equity, and Sustainability in Head and Neck Cancer Surgery: A Structured Narrative Review.Epidemiologia (Basel, Switzerland) · 2026Review
- Grid carbon intensity drives the electricity-related carbon footprint of robot-assisted radical prostatectomy: a cross-jurisdiction modelling study.Scientific reports · 2026Article
- Exploring the overuse of non-sterile gloves in operating theatres: a cross-sectional survey and interview study.BMJ open · 2026Article
- Article
- Environmental impact of orthodontic treatment: a simplified fast-track comparative life-cycle impact assessment of self-ligating metal brackets and clear aligners.European journal of orthodontics · 2026Article
- Enablers and barriers for using reusable trocars: a qualitative study of surgeons' and residents' perspectives.Surgical endoscopy · 2026Article
- Twin Transformation in Cardiothoracic Surgery: The Convergence of Digital Innovation and Sustainability.Journal of cardiovascular development and disease · 2026Review
- A Survey of Single-Use and Reusable Surgical and Anaesthetic Devices in Victorian Public Health Services.ANZ journal of surgery · 2026Article
- Multicenter study protocol on clinical, environmental, and economic outcomes of hybrid versus disposable surgical trays (project rEUsable).International journal of surgery protocols · 2026Article
- Article
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSustainability in healthcare is a rapidly developing area of research with recent formal recognition from institutions around the world. We completed an update of a systematic review published in 2020. The aims of this review were to determine the reported carbon footprints of surgical operations in hospitals worldwide, identify variations in reported carbon footprints and highlight carbon hotspots associated with surgery.
methodsA systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. The MEDLINE
results1,308 articles were identified and 7 met the inclusion criteria for the review. The carbon footprint ranged from 28.49kg to 505.1kg carbon dioxide equivalents (CO
conclusionsThis systematic review identifies medical devices and consumables as the largest carbon hotspot where healthcare providers should target their sustainability initiatives. Nevertheless, the number of studies was limited and the quality of the evidence was weak. We recommend that researchers in healthcare sustainability develop international standards for conducting and reporting such studies. This would allow for comparison of individual studies and facilitate meta-analysis of cumulative evidence. A reliable evidence base is a prerequisite for identifying optimal interventions to ensure societal benefits.
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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.