Presentation (CTI)

OBJECTIVES: An emerging body of literature on the study of the carbon footprint generated within the operating room (OR) is growing, specifically whether the surgical approach (open, laparoscopic, or robotic assisted surgery (RAS)) makes a difference. Most evaluations of the carbon footprint generated within the OR do not extend their assessments to post-operative recovery. We develop a model to estimate carbon avoidance, related to perioperative outcomes beyond the operating across three surgical modalities.
METHODS: A carbon avoidance model was build using clinical data from a published meta-analysis by Ricciardi R et al., a literature review of energy use, and material waste to determine a custom emissions factor, necessary to estimate carbon avoidance for the hospital during the perioperative period. Perioperative clinical outcomes used were conversion to open surgery, blood transfusions, hospital length of stay and readmissions.
RESULTS: The findings show that 2,653,093 RAS procedures performed using the da Vinci system resulted in a carbon avoidance of 94.09 kg CO2e per procedure compared to open surgery, and 39.17 kg CO2e per procedure compared to laparoscopic surgery. The carbon avoidance was most sensitive to length of hospital stay, and readmissions. Total carbon avoidance resulting from RAS was 249,618,361.44 kg CO2 e in comparison to open surgery in 2024. In everyday terms, this amount of carbon avoidance is equivalent to 550,136,255 miles driven by an average gasoline-powered passenger vehicle.
CONCLUSIONS: Carbon avoidance beyond the OR itself can be quantified and is dependent on surgical approach. RAS using the da Vinci system results in higher carbon avoidance in comparison to open and laparoscopic surgery. Further study in this field is warranted.