Use less, waste less: Rethinking consumable use in proctology

Area of Science:

• Surgical Innovation
• Waste Reduction in Healthcare
• Infection Prevention Strategies

Background:

• Proctology procedures are material-intensive despite being short and common.
• The surgical site in proctology (distal gut) is inherently contaminated with bacteria, making complete sterility unattainable.
• Routine sterile set-up in proctology is contestable due to the non-sterile nature of the surgical field.

Purpose of the Study:

• To advocate for a disciplined, indication-based approach to benign anorectal surgery.
• To challenge the necessity of routine sterile consumables when the surgical field is already contaminated.
• To propose a low-waste surgery model for proctology.

Main Methods:

• Evaluating the necessity of routine sterile drapes and consumables.
• Suggesting the use of clean, non-sterile protective equipment for proceduralists where appropriate.
• Recommending opening suction and diathermy only when required, rather than routinely.
• Maintaining standard protocols for instrument sterility, aseptic handling, skin preparation, sharps safety, and antibiotic prophylaxis.

Main Results:

• Routine sterile consumables are not always necessary in proctology due to the contaminated surgical site.
• A reduction in opened sterile items can be achieved by opening them on demand.
• Selected cases may still require a conventional sterile set-up for infection prevention.

Conclusions:

• Proctology can serve as a model for low-waste surgery by minimizing routine sterile supply use.
• An indication-based approach, opening items on demand, and true material recovery are key to reducing waste.
• Infection prevention principles should guide decisions, but habit should not dictate the use of unnecessary sterile consumables.