The environmental burden of surgical waste from endovascular aortic aneurysm repair

<h2>Abstract</h2><h3>Background</h3> The health sector plays a significant role in contributing to climate change owing to its considerable carbon footprint. Operating rooms are responsible for producing up to one-third of the total waste generated by hospitals. To assess the environmental impact of endovascular aneurysm repair (EVAR), we conducted a surgical waste audit to evaluate waste production associated with this procedure. <h3>Methods</h3> We conducted a waste audit on 30 EVAR procedures performed by the vascular department. The waste was categorized into six streams: regular solid waste, recyclable plastics, recyclable paper, biohazard waste, laundered linens, and sharps. The volume and weight of each stream were measured and quantified. Using Canadian hospital discharge abstract data (2003-2016), we estimated the annual weight and volume totals of waste generated from all EVAR procedures performed in Ontario. <h3>Results</h3> The average surgical waste (excluding laundered linens) per EVAR was 20.72 kg, of which 13.3 kg (64.2%) was normal solid waste, 2.71 kg (12.8%) was biohazard waste, 2.44 kg (12%) was device boxes, 2.09 kg (10.1%) was recyclables, and 0.18 kg (0.9%) was sharps. The average volume of waste per EVAR was 0.77 m³. Device packaging made a significant contribution to the total waste. We estimated that landfill waste from the 19,219 elective EVAR procedures performed in Ontario between 2003 and 2016 amounted to 392,067 kg by weight and 14,798 m³ by volume. <h3>Conclusions</h3> EVARs generate substantial surgical waste. By adopting environmentally friendly surgical products and implementing effective waste management policies, operating rooms could significantly reduce their environmental impact without compromising patient care.