Sustainability in surgery: insights from the 2024 SAGES Annual Meeting

The healthcare sector is a major contributor to global carbon emissions, with operating rooms representing particularly waste-intensive environments. Despite growing interest in sustainability in surgery, little qualitative research has explored surgeons' and surgical trainees' perceptions of this issue or their responses to professional society sustainability initiatives.

This qualitative study used semi-structured, in-depth interviews with surgeons and surgical trainees who attended at least one sustainability session at the 2024 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Annual Meeting. Purposive sampling was used to recruit participants, and interviews were conducted in person or via Zoom. Transcripts were analyzed using the framework method with an abductive approach to coding. Domains and themes were generated using constant comparison.

18 participants were interviewed, including surgeons, fellows, and residents from academic and community settings. Two major domains emerged: (1) attitudes and perceptions of sustainability in surgery and (2) responses to the 2024 SAGES Annual Meeting's sustainability agenda. Participants conceptualized sustainability as both mindful resource use and concrete waste-reduction actions. The operating room was widely viewed as a highly wasteful environment. Sustainability sessions were perceived as educational, motivating, and impactful, particularly through leadership engagement and the presentation of quantitative environmental data. Many participants reported increased awareness and expressed intentions to implement sustainable changes in their own practices.

Participants demonstrated strong support for sustainability initiatives and viewed the SAGES sustainability sessions as a catalyst for individual and institutional change. These findings highlight the influential role of professional societies, leadership, and data-driven education in advancing sustainability in surgical practice.