Impact of drug-induced sleep endoscopy on sustainability: A STROBE-analysis

Drug-induced sleep endoscopy (DISE) is widely used for assessment of obstructive sleep apnea, using either disposable or reusable fiberendoscopes. The present study compared the environmental, economic and social impact of DISE between disposable and reusable fiberendoscopy.

Ten DISE procedures were analyzed. The carbon footprint, expressed in kgCO₂eq, included patient and staff transport, operating room energy consumption, waste management, medical device production, delivery, and sterilization. Financial costs and healthcare professionals' perceptions were also evaluated via structured questionnaires.

The baseline carbon footprint of a DISE procedure (excluding the endoscope) was 23.95kgCO₂eq. Using a disposable fiberendoscope increased the total footprint to 65.05kgCO₂eq, while a reusable endoscope resulted in an extra 14.18kgCO₂eq. Financially, a single procedure cost €206 with the disposable device versus €17.60 with the reusable one. Professionals associated reusable fiberendoscopes with better quality, ecological benefit and lower cost, but noted concerns about infection control and the complexity of sterilization. Disposable devices were preferred for their ease of use but criticized for their environmental and economic impact.

Reusable fiberendoscopes offer clear environmental and economic advantages over disposable ones, without compromising clinical outcome. Promoting their use can help reduce the ecological footprint of healthcare systems while maintaining high-quality care.