Advancing Sustainability in Gynecologic Surgery: 12 Practical Steps to Reduce Environmental Impact

Highlight

• Gynecologic surgery significantly contributes to healthcare-related carbon emissions, primarily due to single-use disposables.
• A 12-step approach focused on minimizing disposable products and optimizing resource use can substantially reduce the environmental footprint of gynecologic operative care.
• Evidence supports replacing disposable tools with reusable alternatives and customized surgical practices that balance safety, efficacy, and sustainability.
• Implementing these strategies collectively can promote eco-friendly surgical environments without compromising clinical outcomes.

Background

Healthcare is a notable contributor to global greenhouse gas emissions, with surgery recognized as a major driver within hospitals due to its extensive use of energy and disposable materials. Gynecologic surgery, encompassing procedures such as hysterectomy, cystectomy, and minimally invasive interventions, often relies heavily on single-use instruments and consumables, magnifying its environmental impact. Against the backdrop of growing climate change concerns, there is an increasing imperative to adopt sustainable practices in surgical care that reduce carbon emissions and waste production while maintaining patient safety and procedural efficacy.

Study Design

Schneyer et al. present a pragmatic, evidence-informed framework of 12 strategies aimed at reducing environmental impact specifically in the gynecologic operating room. Although no comparative clinical trial was performed, these strategies are accompanied by data derived from lifecycle assessments and institutional experiences to support their environmentally beneficial effects. The focus is on interventions that reduce the consumption of single-use disposable products and optimize material use during surgical procedures.

Key Findings

The 12 strategies to enhance sustainability in gynecologic surgery are:

1. Reduce Glove Changes: Rationalizing glove changes during operations lowers material use and waste without compromising sterility when done judiciously.
2. Custom Surgical Packs: Tailoring surgical packs to include only necessary instruments minimizes unused items and packaging waste.
3. Reusable Scrub Caps: Using washable, reusable scrub caps instead of disposables decreases textile waste and carbon footprint.
4. Avoid Disposable Energy Devices: Opting for reusable electrocautery and energy-based devices reduces reliance on disposables and packaging waste.
5. Stainless Steel Manipulators: Replacing plastic uterine manipulators with reusable stainless steel versions cuts plastic waste and resource consumption.
6. Reusable Suction Irrigators: Utilizing reusable suction and irrigation devices limits single-use plastic waste.
7. Alternatives to Specimen-Retrieval Bags: Employing reusable specimen retrieval systems or alternatives decreases plastic bag usage.
8. Minimize Single-Use Plastic Trocars: Favoring reusable trocars over disposable options safeguards against excess plastic waste.
9. Avoid Advanced Access Platforms: Foregoing disposable multi-channel access devices where possible reduces material consumption.
10. Make the Most of Every Suture: Efficient use of sutures, including utilizing all available lengths, helps prevent unnecessary waste.
11. Use a Laparoscope for Cystoscopy: Employing laparoscopes as a versatile tool for cystoscopy reduces the need for separate disposable cystoscopes.
12. Minimize Red Bag Waste: Limiting red biohazard bag waste by accurate segregation practices cuts unnecessary disposal demands.

Each initiative individually contributes a modest reduction in environmental impact, yet cumulatively, these steps can lead to significant decreases in carbon emissions and waste generation associated with gynecologic surgery. The authors emphasize that sustainability should be integrated as a core value in surgical workflow design and decision-making.

A toolkit with additional resources is available in Appendix 1, available online at http://links.lww.com/AOG/E234

Expert Commentary

Healthcare sustainability experts recognize the challenge of balancing infection control, surgical efficacy, and environmental responsibility. The 12-step approach by Schneyer et al. reflects growing consensus on prioritizing reusable equipment and minimizing disposable supplies without compromising safety. This is in line with recommendations from sustainability frameworks endorsed by surgical societies and environmental health organizations. Critics may note that the transition to reusable devices requires upfront investment in sterilization infrastructure and workflow changes; however, lifecycle analyses typically show cost savings and environmental benefits over time. Future research may assess the clinical outcomes and economic effects of implementing these strategies in multi-center trials.

Conclusion

The 12 practical steps for sustainability in gynecologic surgery provide a clear roadmap to reduce the environmental footprint of surgical care. By minimizing the use of single-use disposables and engaging in resource-conscious practices, surgical teams can contribute meaningfully to climate change mitigation efforts. Adoption of these strategies requires institutional support, education, and ongoing evaluation to ensure that patient safety and procedural quality remain paramount. This toolkit equips surgeons and healthcare systems with actionable measures that, when combined, hold substantial promise to advance greener operating rooms and sustainable gynecologic practice.

Funding and ClinicalTrials.gov

The original article did not specify funding sources or clinical trial registrations.

References

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