A Comparison Study Quantifying Environmental Impact of All Surgical Modalities of Hysterectomies

Abstract

<h3>Study Objective</h3> Compare carbon dioxide emissions generated from operating room waste from all types of hysterectomies. Improving provider awareness on the environmental impact of hysterectomies may facilitate interventions to minimize our carbon footprint. <h3>Design</h3> A prospective cohort study was conducted, including patients who had a hysterectomy for any indication. Surgical waste in pounds (lbs), procedure data, and patient demographics was collected for each case. The formula below was used to identify the emissions generated for each procedure: <i>CO2 emissions = Waste in pounds (lbs) x 1 short ton/2000 lbs x EPA emission factor (kg CO2 per short ton) x global warming potential</i> <h3>Setting</h3> A 305-bed Level II Trauma center and academic teaching hospital, 11/2021 – present. <h3>Patients or Participants</h3> A total of 81 women ≥ 18 years of age underwent a scheduled hysterectomy (robotic assisted, laparoscopic, vaginal, abdominal) for benign or malignant indications at one institution. We excluded women < 18 years of age and emergent hysterectomies (i.e., postpartum hysterectomy). Data collection is ongoing with the goal of reaching a sample size of 100. <h3>Interventions</h3> Waste that was generated for every hysterectomy was weighed by the Primary Investigator. <h3>Measurements and Main Results</h3> Among the 81 cases analyzed, there was no significant difference between groups in age, ethnicity, and BMI. The total waste generated by each type of hysterectomy ranges from lowest (vaginal, 3 lbs.) to highest (robotic, 46 lbs.). CO2 emissions was significantly higher for robotic hysterectomies (57%, <0.0001) when compared to the other types. 100% of robotic hysterectomy waste contributed more than the mean CO2 emission of our sample. There was no significant association between duration of surgical case and amount of waste generated. Additional analysis in progress. <h3>Conclusion</h3> Robotic hysterectomies were found to generate a statistically significant majority of CO2 emissions. Additional studies are needed to determine the environmental impact and strategies to reduce our carbon footprint.