Environmental Impact of Minimally Invasive Radical and Partial Nephrectomy: A Multicenter Prospective Comparative Study Comparing Robot-Assisted and Laparoscopic Surgical Approaches
Background: Minimally invasive surgery has improved patient outcomes but raises environmental concerns due to carbon emissions from disposable instruments, energy consumption, and hospital resource use. This study evaluates the carbon footprint of robot-assisted and laparoscopic nephrectomies. Methods: A multicenter prospective study analyzed 162 patients undergoing robot-assisted or laparoscopic partial (RAPN, LPN) and radical nephrectomy (RARN, LRN). Life cycle assessment (LCA) quantified CO2 emissions from instrument use, sterilization, and energy consumption. Results: Robot-assisted procedures had lower CO2 emissions than laparoscopic approaches. Emissions from instrument disposal were 9.04 kg in RAPN vs. 12.14 kg in LPN (p = 0.02) and 8.74 kg in RARN vs. 11.45 kg in LRN (p = 0.03). Despite higher intraoperative energy use, robot-assisted surgery produced 3–4 kg less CO2 per procedure due to reusable instruments and shorter hospitalization. Conclusions: Robot-assisted nephrectomy reduces environmental impact by minimizing waste and hospital stays. Efforts should focus on reusable instruments, energy efficiency, and sustainability initiatives to mitigate surgical carbon footprints while ensuring high-quality care.
Authors
- Giorgio Martino
- Damiano Graziani
- Alessandro Sciarra (ORCID: https://orcid.org/0000-0002-7899-8056)
- Onofrio Antonio Rera (ORCID: https://orcid.org/0000-0003-4684-632X)
- Antonio Carbone (ORCID: https://orcid.org/0000-0003-1725-1933)
- Alessandro Zucchi (ORCID: https://orcid.org/0000-0003-2252-4297)
- Andrea Fuschi
- Anastasios D. Asimakopoulos (ORCID: https://orcid.org/0000-0002-7230-579X)
- Alessandro Corsini (ORCID: https://orcid.org/0000-0002-7291-1116)
- Manfredi Bruno Sequi (ORCID: https://orcid.org/0000-0002-0578-5738)
- Matteo Pacini (ORCID: https://orcid.org/0009-0000-7293-1304)
- Antonio Luigi Pastore (ORCID: https://orcid.org/0000-0003-4293-9174)
- Fabio Maria Valenzi (ORCID: https://orcid.org/0009-0005-5830-0975)
- Alice Antonioni
- Stefano Nardecchia
- Giorgio Bozzini (ORCID: https://orcid.org/0000-0001-6274-314X)
- Flavia Carbone
- Yazan Al Salhi (ORCID: https://orcid.org/0009-0005-1707-9485)
- Riccardo Lombardo (ORCID: https://orcid.org/0000-0003-2890-3159)
- Cosimo De Nunzio (ORCID: https://orcid.org/0000-0002-2190-512X)
- Giuseppe Candita
- Paolo Pietro Suraci
- Filippo Gianfrancesco
Institutions
- University of Pisa (IT)
- Policlinico Umberto I (IT)
- Azienda Socio Sanitaria Territoriale Lariana (IT)
- Policlinico Tor Vergata (IT)
- Ospedale Sant'Anna (IT)
- Sapienza University of Rome (IT)
- Politecnico di Milano (IT)
Publication Details
- Journal
- Applied Sciences
- Published
- 2025-05-02
- DOI
- https://doi.org/10.3390/app15095079
- Primary Topic
- Renal cell carcinoma treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00