Khalil George M, Khan Nida, Kamalathasan Jaciron, Qasim Muhammad, Ahmed Reem, Sajid Muhammad S
Department of Digestive Disease and General Surgery, Royal Sussex County Hospital, Brighton, GBR.
Department of General Surgery, Brighton and Sussex Medical School, Brighton, GBR.
Cureus. 2025 May 27;17(5):e84870. doi: 10.7759/cureus.84870. eCollection 2025 May.
Introduction Climate change is a significant global challenge as a result of rising greenhouse gas emissions. The National Health Service (NHS), as one of the biggest contributors to the United Kingdom's emissions, has a net-zero carbon emissions target. Operating theatres have a large resource burden in hospitals, and the laparoscopic appendicectomy (LA) is one of the most commonly performed procedures. As of yet, the laparoscopic appendicectomy has not been effectively carbon footprinted. Aims The objective of this study is to calculate the carbon footprint of the laparoscopic appendicectomy (LA) in grams of carbon dioxide (CO2) produced that results in an environmental impact. In addition, we also identify the biggest contributors to the carbon footprint and create a set of recommendations for CO2 emission reduction. Methods Carbon footprint-related data was collected for using surgical equipment, electricity utilisation and consumption of CO2 used for pneumoperitoneum, over 23 consecutive LAs. Peer-reviewed literature was used to determine the footprint of the equipment via a lifecycle assessment. The average carbon emissions for pneumoperitoneum, theatre overheads (mainly heating, ventilation and air conditioning (HVAC)) and electrical equipment were calculated. Results The average CO2 emission for an appendicectomy was 28258±1256 (24381-36267) grams. Variation was largely secondary to prolonged operations (Spearman's rank correlation coefficient = 0.95) due to technical difficulties. Major contributors in carbon footprinting were pre-set (reusable items) (23%), pre-set (disposable items) (40%), theatre overheads (HVAC and lights) (16%), CO2 pneumoperitoneum (9%), scrubs and personal protective equipment (PPE) (6%), additional equipment (5%) and utilisation of electrical equipment (1%). Conclusion The LA is a carbon-intensive procedure. CO2 emissions from LAs may be reduced by switching over to reusable equipment and increasing operating room efficiency. The green theatre checklist provides excellent guidelines on this. More research is needed into less environmentally impactful gases to achieve a pneumoperitoneum. This study provides data to guide targeted interventions and quantify the degree of offsetting needed to achieve net-zero emissions for laparoscopic surgery.
引言 气候变化是温室气体排放增加带来的一项重大全球挑战。英国国家医疗服务体系（NHS）作为英国碳排放的最大贡献者之一，设定了净零碳排放目标。手术室在医院中资源负担巨大，而腹腔镜阑尾切除术（LA）是最常开展的手术之一。到目前为止，腹腔镜阑尾切除术尚未得到有效的碳足迹核算。
目的 本研究的目的是计算腹腔镜阑尾切除术（LA）产生的以二氧化碳（CO₂）克数表示的碳足迹，该碳足迹会产生环境影响。此外，我们还确定了碳足迹的最大贡献因素，并制定了一套减少二氧化碳排放的建议。
方法 连续收集了23例腹腔镜阑尾切除术使用手术设备、电力消耗以及气腹用二氧化碳消耗的碳足迹相关数据。通过同行评审文献，经由生命周期评估来确定设备的碳足迹。计算了气腹、手术室间接费用（主要是供暖、通风和空调（HVAC））以及电气设备的平均碳排放量。
结果 阑尾切除术的平均二氧化碳排放量为28258±1256（24381 - 36267）克。由于技术困难导致手术时间延长，差异在很大程度上是次要因素（斯皮尔曼等级相关系数 = 0.95）。碳足迹的主要贡献因素包括预设（可重复使用物品）（23%）、预设（一次性物品）（40%）、手术室间接费用（HVAC和照明）（16%）、二氧化碳气腹（9%）、手术服和个人防护装备（PPE）（6%）、额外设备（5%）以及电气设备使用（1%）。
结论 腹腔镜阑尾切除术是一个碳密集型手术。通过改用可重复使用设备和提高手术室效率，可以减少腹腔镜阑尾切除术的二氧化碳排放。绿色手术室清单对此提供了很好的指导方针。需要对环境影响较小的气体进行更多研究以实现气腹。本研究提供的数据可指导有针对性的干预措施，并量化实现腹腔镜手术净零排放所需的抵消程度。
