Eco-Audit of the Da Vinci Robot in Minimally-Invasive Surgery: A Comparison with Conventional Technique for Lobectomy

This study provided an important profile of the carbon footprint resulting from a lobectomy operation conducted in the HPL (a private hospital of Loire, France) using RATS (robotic-assisted surgery with da Vinci platform) and conventional VATS (video-assisted surgery with laparoscope) techniques.Our analysis aims to quantify their carbon impact and identify major sources of energy expense according to the eco-audit method.A mitigating indicator based on an estimation of the green-house emission (GHE, in kilogram carbon dioxide equivalent emissions) has been provided, which depends on materials' quantity and emission factors computed from the life-cycle-assessment (LCA) software.For the same procedure, the RATS lead to ~ 32% higher carbon impact with respect to the conventional VATS.It has been demonstrated that, whatever the technique is chosen (either with or without robot), the majority of surgical tools consume the most energy for production and manufacture.Inversely, little electrical power is needed during use, as most of them are passive and their lifetime is relatively short (i.e., minute tools for single use like needles, scalpels, scissors, forceps, etc.).Development of sustainable surgical devices with the possibility of being reusable or recycling seems to be an interesting alternative to drop carbon emission.Nonetheless, the reusable set needs significant energy for washing and steam sterilization, which has a higher carbon impact than the disposable counterpart.Recycling plastics and metals, together with the use of bio-polymers instead of oil-based polymers might reduce the environmental burden.However, what is the price, the surface of land, as well as the water consumption needed to fabricate those bio-polymers?Also, what is the full LCA for recycling and reusing?Before going further with reflection and decision, we need to look objectively at the concrete situations to identify advantages and conveniences of each measure.These concerns, accompanied by scientific and methodological analyses, will be revealed in this study.