Evidence map›Paper›PMID 41269314›Full record

ArticleSurgical endoscopy2026

Assessing the carbon footprint of surgical materials: a comparative study of open, endoscopic, and robotic approaches in four major operations.

Yoshimasa Akashi, Tsuyoshi Enomoto, Ayumi Shikama, Hideo Ichimura, Koichi Ogawa, Yohei Owada, Kinji Furuya, Kazuhiro Takahashi, Osamu Shimomura, Yoshihiro Miyazaki and 4 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. The Cost of Progress that Pays Off.Annals of surgical oncology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Yoshimasa AkashiDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. yakashi@md.tsukuba.ac.jp.ORCID 0000-0003-0589-3816
Tsuyoshi EnomotoDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Ayumi ShikamaDepartment of Gynecology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Hideo IchimuraDepartment of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Koichi OgawaDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Yohei OwadaDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Kinji FuruyaDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Kazuhiro TakahashiDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Osamu ShimomuraDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Yoshihiro MiyazakiDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Shuntaro TsukamotoDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Tomoaki FurutaDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Hiromitsu NakahashiDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Tatsuya OdaDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.

Funding

Japan Society for Endoscopic Surgery 2023Japan Society for Endoscopic Surgery Grant for environmental research
6 · The paper itself

Abstract

backgroundSurgery is an energy-intensive medical field, and its contribution to the environment is significant. Robotic surgery (RS) may generate a greater carbon footprint than open surgery (OS) or endoscopic surgery (ES). However, the extent of this impact has not been fully evaluated in major cancer surgeries.

methodsWe focused on surgical materials (classified as Scope 3 in the greenhouse gas protocol) and compared the carbon footprints of RS, ES (laparoscopy or video-assisted thoracoscopy), and OS across four major cancer-related procedures. An approximate process-based life cycle assessment approach was used to calculate the carbon footprint (CO

resultsRS had a higher carbon footprint than ES and OS in all four procedures, and robot-assisted low anterior resection had the highest carbon footprint (27.89 kg CO

conclusionRobotic approach had the highest carbon footprint in all four cancer surgeries, and alternatives using only reusable products are insufficient to offset the increase. To ensure the sustainability of robotic surgery, all stakeholders must continue to implement environmental initiatives, such as optimizing surgical materials and developing eco-friendly products.

Indexed as

Carbon FootprintLaparoscopyRobotic Surgical ProceduresHumansCarbon footprintEndoscopic surgeryGreenhouse gas emissionsOpen surgeryRobotic surgerySustainability

Identifiers

PMID41269314

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.