Assessment of the environmental and economic performance for developing more circular trocar systems in healthcare

• Reusable trocars can reduce climate change impacts by up to 91 % compared to single-use. • Recycling trocars is more sustainable than incineration, lowering waste impacts. • Reusable systems offer cost savings despite higher initial purchase expenses. • Sustainable procurement can significantly cut healthcare's environmental footprint. • Future research should assess healthcare staff perspectives on circularity adoption. To address the pressing need for sustainability in healthcare and reduce plastic waste, this study assesses the environmental and economic impacts of plastic trocars in Stockholm's healthcare sector. Using life cycle assessment (LCA) and life cycle costing (LCC) across seven scenarios, the findings reveal that the Reusable-recycling scenario reduced environmental impacts—lowering the climate change potential (kg CO 2- eq) by 91 %, resource use, fossil (MJ) by 62 %, and resource use, minerals, and metals (kg Sb-eq) by 64 %—compared to the current Single-use incineration scenario. Additionally, the reusable system proved to be the most cost-effective despite a higher purchase cost. This research contributes to the academic understanding of circular strategies in healthcare by providing insights into the economic and environmental performance of medical devices. The findings also inform policymakers, highlighting the need for investment in sterilization and recycling infrastructure to support reusable systems and advance sustainable healthcare practices aligned with a circular economy.