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Carbon emissions and waste consumption of infant inguinal hernia repair: a prospective analysis
Asha Hui1, Hooria Bilal1, Riichi Rohit Mazi1
1University of British Columbia, Vancouver, Canada.
Insights
Infant inguinal hernia repair (IHR) using laparoscopy generates more waste but has similar carbon emissions compared to open surgery. The environmental impact should not dictate the surgical approach for pediatric IHR.
Area of Science:
- Pediatric Surgery
- Environmental Science
- Anesthesiology
Background:
- Inguinal hernia repair (IHR) is a common pediatric surgical procedure.
- Various surgical and anesthetic techniques exist for infant IHR.
- Understanding the environmental impact of these procedures is crucial for sustainable healthcare.
Purpose of the Study:
- To quantify and compare the environmental impact of open versus laparoscopic infant inguinal hernia repair.
- To analyze waste generation and carbon emissions associated with anesthesia and surgical processes.
- To inform surgical decision-making based on environmental considerations.
Main Methods:
- Prospective observational study of pediatric patients under 1 year undergoing elective IHR.
- Data collected on operative and anesthetic processes, including waste generated per case.
- Measurement of total CO2 equivalent from inhaled anesthesia and CO2 used for insufflation.
- Statistical analysis using Welch's t-test with significance at p < 0.05.
Main Results:
- Laparoscopic IHR generated 22.3% more non-recyclable waste than open IHR (p=0.0081).
- No significant difference was found in recyclable waste (p=0.291) or total CO2 emissions (p=0.6936) between the two methods.
- CO2 emissions from direct insufflation during laparoscopy accounted for only 7% of the total.
Conclusions:
- Laparoscopic infant IHR produces more physical waste but comparable total CO2 emissions to open IHR.
- The overall carbon footprint of both procedures is similar, suggesting environmental impact should not be the primary factor in choosing the technique.
- Further research into environmental stewardship in pediatric surgery is recommended.
Purpose:
Inguinal Hernia Repair (IHR) is a common pediatric procedure with different surgical and anesthetic options. This project quantified and compared differences in environmental impact by analyzing waste generation and carbon emissions arising from anesthesia and surgical processes for infant IHR.
Methods:
A prospective, observational study of pediatric IHR cases in elective patients aged < 1 year was conducted over 1 year. Data collection included operative and anesthetic processes, as well as waste generated/case. Total CO2 equivalent from inhaled anesthesia was measured, along with the volume of CO2 used for insufflation. Welch's t-test was used for analysis, with p < 0.05 considered significant.
Results:
Twenty-two patients were enrolled, 13 underwent open IHR and 9 underwent laparoscopic IHR, using a combination of anesthetic techniques. Laparoscopy produced 22.3% more non-recyclable waste than open procedures (p = 0.0081); no difference in recyclable waste (p = 0.291) or total CO2 emissions (p = 0.6936). On average, only 7% of CO2 emissions arose from direct insufflation during laparoscopy.
Conclusion:
Laparoscopy for infant IHR generates more physical waste but produces comparable total CO2 emissions when compared to the open procedure. The overall carbon footprint of either procedure appears similar, suggesting the planetary impact of these procedures shouldn't influence choice of technique. More research into environmental stewardship is warranted.