Environmental impact of current endoscopic technology in urological procedures: a systematic review on reusable vs. disposable scopes.

PURPOSE

To systematically evaluate and synthesize the existing literature on environmental aspects related to urological endoscopy procedures.

METHODS

A literature search was conducted through January 2024 using PubMed/Medline, and Web of Science databases. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify eligible studies.

RESULTS

The review reveals varying environmental footprints across procedures. In cystoscopy, studies suggest that disposable scopes result in decreased waste and water usage compared to reusable ones. However, life-cycle assessments did not conclusively highlight environmental superiority in favor of disposable devices. This discrepancy might dwell in the reprocessing methods used for the reusable cystoscopes that vary greatly among centers. For ureteroscopy, studies tend to show comparable carbon footprints for disposable and reusable scopes. Regarding transurethral resection of bladder tumors, a shift towards day-case surgery is associated with a substantial reduction in carbon emissions. Transurethral prostatic surgery assessments reveal significant discrepancies in the carbon footprints of disposable minimally invasive surgical devices, highlighting the need for recycling programs and manufacturing modifications.

CONCLUSIONS

This review shed light on the necessity to develop strategies to reduce environmental impact such as individual assessments of single-use devices, optimizing reusable scope reprocessing, reconsidering the use of draping during cystoscopies, and minimizing hospital stays. This study serves as a call to industries to conduct similar audits and standardized studies for healthcare products and services, fostering evidence-based decisions to mitigate the environmental impact of urological endoscopy procedures.