Laparoscopic versus robot-assisted left hemicolectomy: A pilot study on sustainability

Area of Science:

• Surgical Innovation
• Environmental Sustainability in Healthcare
• Minimally Invasive Surgery

Background:

• The National Health System contributes significantly to greenhouse gas emissions (8-10%).
• Operating rooms generate 60-70% of hospital waste.
• The environmental impact of robot-assisted surgery, particularly in colorectal procedures, is understudied.

Purpose of the Study:

• To compare the environmental sustainability of robot-assisted versus laparoscopic left hemicolectomy.
• To investigate CO2 consumption and waste production in these surgical approaches.

Main Methods:

• A pilot study involving patients undergoing minimally invasive left hemicolectomy.
• Random assignment to either laparoscopic or robot-assisted groups (1:1 ratio).
• Segregated waste collection and measurement of CO2 consumption and waste mass.

Main Results:

• Robot-assisted left hemicolectomy consumed more CO2 for pneumoperitoneum (p=0.03) and had longer operation times (p=0.04).
• Robot-assisted approach generated 74.5 kg of waste, compared to 54 kg for the laparoscopic approach.
• Disposal costs were higher for robot-assisted surgery (€92) versus laparoscopic (€71).

Conclusions:

• Robot-assisted left hemicolectomy appears to have a greater environmental impact than the laparoscopic approach.
• Increased CO2 emissions and waste production are key concerns.
• Further comparative studies are essential to guide sustainable surgical practice.