Practical strategies for environmentally sustainable practices in gynecologic oncology

Sustainability in health care is an increasingly urgent priority, and gynecologic oncology (as a resource-intensive surgical specialty) offers opportunities to reduce environmental impact without compromising patient care. This review provides actionable, evidence-based strategies that individual clinicians, departments, and institutions can readily implement into routine practice. Practical anesthetic strategies, such as total intravenous anesthesia, regional anesthesia, and low-flow techniques, substantially decrease greenhouse gas emissions. Transitioning from disposable to reusable surgical instruments, drapes, and gowns significantly curbs waste. Energy-efficient solutions in the operating room, including optimized heating, ventilation, air conditioning systems, as well as light emitting diode lighting, minimize unnecessary energy use. Optimizing diagnostic imaging through clinical justification and powering down equipment when feasible further decreases energy consumption. Pharmaceutical-related strategies, including accurate chemotherapy dosing, safe medication disposal through drug take-back programs, and environmentally conscious procurement, mitigate harmful emissions and pharmaceutical waste. Surgical techniques such as sentinel lymph node biopsy, rather than extensive lymphadenectomy, also support sustainability goals by reducing resource consumption and procedural waste. Digital innovations, notably telemedicine, demonstrate clear environmental advantages by minimizing patient travel, particularly for routine follow-up and the collection of patient-reported outcomes. Enhanced Recovery After Surgery protocols, promoting shorter hospital stays and digital preoperative assessments, represent additional avenues for improvement. Preventive interventions, such as human papillomavirus vaccination programs and early cancer screening, are vital long-term sustainability investments, reducing resource-intensive treatments associated with advanced disease. By highlighting practical examples from recent studies and clinical experience, this review aims to encourage widespread adoption of sustainable practices in gynecologic oncology, aligning clinical excellence with global environmental goals.