Resident Oregon Health & Science University Portland, Oregon, United States
Introduction: The healthcare sector is responsible for up to 4.6% of worldwide greenhouse gas emissions, with the United States’ healthcare system being responsible for about a quarter of global healthcare emissions. Premature mortality related to healthcare pollution has been found to be on par with that due to preventable medical errors. Despite this, studies on the environmental impact of surgical operations, particularly within the field of neurosurgery, remain largely unexplored. The goal of this review is to identify existing literature on this subject with respect to the scope and scale of the problem, as well as potential solutions pertinent to neurosurgery.
Methods: The PubMed database (US National Library of Medicine) was used to identify all articles published through September 2022 topically related to operating room sustainability practices and carbon footprints with attention paid to neurosurgery. Full-text articles were reviewed to ensure appropriate inclusion. Additional articles were identified through reference lists.
Results: Seven articles were identified directly addressing the environmental impacts of surgery, of which 2 specifically concerned neurosurgery. Studies include 2 systematic reviews, 4 observational studies, and a prospective study of an operating room recycling initiative. Key subdomains included waste production and carbon footprinting, use of disposable materials, and the identification of strategies to reduce and consumption.
Conclusion : There remains a paucity of literature on environmental sustainability practices in surgery, particularly within neurosurgery. Current literature does not fully describe heterogeneity across surgical subspecialties with regard to resource utilization and waste production. Avenues for future research are identified including better characterization of environmental impacts in neurosurgery, identification of current sustainability practices, and prospective interventions to green the neurosurgical operating room.
