ArticleAnnals of surgery2026
Decision-making Factors in Surgical Techniques and Attitudes Towards Environmental Sustainability.
Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Developing a Core Outcome Set for the Evaluation of Remote Patient Monitoring Interventions Using the Sextuple Aim: Modified Delphi Study.Journal of medical Internet research · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveOur study examines factors influencing surgical specialists' choice of surgical technique and assesses the significance of the carbon footprint in this decision-making process. It also investigates their attitudes, behaviors, and barriers to environmental sustainability.
backgroundClimate change significantly threatens health, with surgery being a major contributor to health care's carbon footprint.
methodsA cross-sectional study was conducted using a discrete choice experiment (DCE) and a questionnaire. Respondents were Dutch-speaking surgeons, gynecologists, and urologists with experience in minimally invasive surgery. They judged 14 choice sets, each presenting 2 hypothetical surgical scenarios that varied in postoperative length of stay, patient's preference, specialists' experience, costs, national guideline recommendations, and carbon footprint. The questionnaire explored attitudes, behaviors, and barriers to environmental sustainability.
resultsAmong the 116 respondents, patient's preference emerged as the most important factor in the choice of a surgical technique [relative importance (RI) 27.35 (95% CI: 19.57-35.12], followed by postoperative length of stay [RI 21.41 (95% CI: 14.07-28.75)], specialists' experience [RI 16.07 (95% CI: 11.45-20.69)], costs [RI 13.98 (95% CI: 8.42-19.55)], national guideline recommendations [RI 13.29 (95% CI: 8.41-18.16)] and carbon footprint [RI 7.90 (95% CI: 3.63-12.18)]. Respondents expressed concern about climate change (105/116; 90%), with 85% (98/116) altering personal behaviors, and 49% (57/116) changing work practices. They feel surgical specialists have a responsibility to be aware of surgery's environmental impact (97/116; 84%), and a part has the knowledge to decrease this impact (39/116; 34%). The main barriers are time (73/116; 63%), costs (74/116; 64%), and inadequate training and information (67/116; 58%).
conclusionsPatient preference and postoperative length of stay are prioritized in surgical decision-making, while carbon footprint is the least significant factor. To enhance sustainability in surgical practice, barriers must be addressed, and sustainable techniques and devices should be developed and standardized, ensuring sustainability is inherent in the available options, rather than just relying on individual choice.
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Registered trials
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