Balancing trade-offs in circular medical device design: a case study on laparoscopic devices

This study explores how circular design principles can be applied to single-use laparoscopic staplers to improve their carbon footprint without compromising critical requirements such as safety, performance, and financial feasibility. Using a research-through-design approach, four alternative concepts were developed: a fully recyclable device, a partially reusable device, a multifunctional device, and a manual device, aiming to reduce the carbon footprint while maintaining clinical performance of the device. Iterative design cycles incorporated feedback from Medtech professionals and from qualitative surveys with additional industry stakeholders. Fast-track life cycle assessments (LCAs) estimated environmental impact compared to the baseline device, while stakeholder feedback assessed trade-offs and synergies related to safety, usability, workflow compatibility, and regulatory compliance. Here, "trade-offs" refer to improvements in circularity coming with losses in other requirements, while "synergies" improve both circularity and other requirements together. Results revealed that each concept delivered potential carbon footprint reductions, particularly the reusable, multifunctional, and manual variants. Trade-offs included increased sterilization burden, altered surgical workflow, and reduced user familiarity; synergies included lower material and logistics costs from reuse and multifunctional design, achieved without compromising safety or usability. The findings highlight that achieving circularity in medical device design involves more than technical considerations; it requires a systems-level approach. Effective implementation depends on aligning design strategies with regulatory requirements, clinical workflows, and supply chain practices. This study provides recommendations to navigate trade-offs and identify synergies, supporting a structured approach to advancing sustainable practices in healthcare.

The online version contains supplementary material available at https://doi.org/10.1007/s44498-026-00189-8.