Green endoscopy, one step towards a sustainable future: a review of the literature.

Abstract

Rapid climate change or climate crisis is one of the most serious emergencies of the twenty-first century, accounting for highly impactful and irreversible changes worldwide. Climate crisis can also affect the epidemiology and disease burden of gastrointestinal (GI) diseases as they hold a connection with environmental factors and nutrition. GI endoscopy is a highly intensive procedure with a significant contribution to greenhouse gas (GHG) emissions. Moreover, endoscopy is the third highest generator of waste in healthcare facilities with significant contributions to carbon footprint. Main sources of direct carbon emission in endoscopy are the use of high-powered consumption devices (e.g. computers, anesthesia machines, wash machines for reprocessing, scope processors and lighting), and waste production derived mainly from the use of disposable devices. Indirect sources of emissions are those derived from the heating and cooling of facilities, processing of histological samples, transportation of patients and materials etc. Consequently, sustainable endoscopy and climate change have been the focus of discussions between endoscopy providers and professional societies with the aim of taking action to reduce environmental impact. The term "green endoscopy" refers to the practice of gastroenterology that aims to raise awareness, assess, and reduce endoscopy´s environmental impact. Nevertheless, while awareness has been growing, guidance on practical interventions to reduce carbon footprint of GI endoscopy are lacking. This review aims to summarize current data regarding the impact of endoscopy on GHG emissions and possible strategies to mitigate this phenomenon. Further, we aim to promote the evolution of a more sustainable "green endoscopy".