Pediatric minor procedure rooms generate less waste compared to similar procedures in operating rooms

Operating rooms (ORs) are major contributors to greenhouse gas emissions and hospital waste, producing up to 33 % of a hospital's total waste. Waste in the OR also arises from underutilized surgical instrument trays. Minor procedure rooms (MPR) may offer a lower-waste alternative for appropriate cases. This study compared waste production in MPRs and ORs for common pediatric surgical procedures.

Twelve audits were conducted for three pediatric surgical procedures including adenoidectomy with bilateral myringotomy and tubes (BMT), port removals, and circumcisions. Each procedure was audited twice in both the MPR and OR. GHG emissions (kg CO₂e) associated with audited waste were calculated. Waste streams (recycling, garbage, and biohazardous waste) were measured from setup to case end. Instrument tray photographs were analyzed to assess instrument utilization.

The total waste (MPR vs OR) was 1.83 kg vs 4.30 kg for adenoidectomy/BMT, 2.57 kg vs 5.09 kg for port removals, and 1.07 kg vs 7.98 kg for circumcisions. This reflects waste reductions in the MPR of 57.6 %, 49.5 % and 86.6 %, respectively. Procedures in the MPR contributed an estimated 2.40 kg CO₂e compared to 18.64 kg CO₂e in the OR. The main waste sources in the ORs included disposable anesthesia circuits (20.7 %), single-use personal protective equipment (16.4 %), and textile drapes (15.0 %). The adenoidectomy tray had the highest instrument utilization rate in the MPR (72.7 %) and OR (46.9 %).

The MPR generated less waste than ORs across all procedures, which was associated with lower GHG emissions. Opportunities to further reduce waste include adopting reusable gowns/linens, smaller sterile fields, multi-use anesthesia circuits, and optimizing instrument trays. Expanding the use of MPRs for suitable pediatric surgeries may enhance environmental sustainability in surgical care.