ArticleScientific reports2026
Grid carbon intensity drives the electricity-related carbon footprint of robot-assisted radical prostatectomy: a cross-jurisdiction modelling study.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Electricity consumed during robot-assisted radical prostatectomy (RARP) generates greenhouse-gas emissions that vary with local grid carbon intensity, yet existing environmental reports are mostly single-centre or single-country and therefore cannot separate procedure electricity demand from jurisdictional electricity context. In this cross-sectional modelling study, a standardised intraoperative plug-load model for RARP was linked to publicly available electricity carbon-intensity data from 208 jurisdictions. The base-case demand was 6.5 kW over a reference operative-time distribution with a median of 170 min (IQR 140-180), corresponding to 18.42 kWh per case, with uncertainty propagated to 12.24-20.48 kWh. Structural sensitivity analyses examined robot-only incremental load, low-resource, infrastructure-conditioning, and high plug-load upper-bound settings, together with counterfactual grid-decarbonisation scenarios. Electricity carbon intensity in the archived analytical extraction ranged from 23.8 to 738.8 gCO2eq/kWh, yielding 0.44-13.61 kgCO2eq per case in the base case (median 6.41; IQR 4.19-8.83). Across scenarios, power-demand assumptions changed absolute values, while jurisdictional grid carbon intensity remained the main source of cross-jurisdiction variation within this electricity-only model. Achieving an electricity-related footprint of < 1 kgCO2eq per case required a grid carbon intensity of < 54.3 gCO2eq/kWh and was achieved by 10 jurisdictions in the archived dataset. Within the defined intraoperative plug-load electricity boundary, using life-cycle grid-intensity factors, these results support location-specific reporting and indicate where electricity decarbonisation or operating-theatre energy management can reduce the electricity component of RARP. The analysis is not a full life-cycle assessment of RARP and should be interpreted alongside non-electricity sources such as consumables, sterilisation, anaesthesia, building services, and hospital stay.
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