The impact of vascular surgery procedures on climate change

<h2>Abstract</h2><h3>Introduction</h3> If the healthcare sector were an independent nation, it would be the fifth largest greenhouse gas (GHG) emitter in the world, with operative room waste (ORW) being a significant contributor. However, the specific impact of ORW from vascular surgery procedures remains underexamined. The objective of this study was to examine and compare the ORW produced from open, endovascular, and hybrid vascular procedures. <h3>Methods</h3> A single center, prospective observational review was performed examining all vascular procedures over a six-month period. ORW was measured following each procedure and divided into three categories: disposable, biohazard, and recycling. GHG emissions were then calculated based on established measurements. <h3>Results</h3> A total of 367 procedures were performed by three vascular surgeons at one institution. There was a 93% compliance with data collection by the OR teams. Of these, 329 procedures met criteria for inclusion for analysis: 143 (43%) endovascular, 146 (44%) open, and 40 (12%) hybrid procedures. The mean ORW produced per procedure was 8.36 kgs. Total ORW was significantly higher for hybrid procedures (11.6 kgs) than for endovascular (8.1 kgs; p < 0.001) or open procedures (7.7 kgs; p < 0.001). Endovascular procedures produced significantly greater biohazard waste (1.64 kgs) and recyclable waste (1.23 kgs) compared to open procedures (1.15 kgs; p < 0.05 and 0.44 kgs; p <0.001). However, open procedures produced significantly more disposable waste (6.1 kgs) compared to endovascular (5.2 kgs; p <0.001). Hybrid procedures produced significantly more biohazard waste (3 kgs; p <0.001) and disposable waste (7.3 kgs; p <0.001) compared to open procedures. <h3>Conclusion</h3> Endovascular and hybrid vascular procedures produced significantly more biohazard waste compared to open vascular procedures. Biohazard waste creates up to three times the GHG production compared to non-biohazard ORW. While the healthcare sector must identify numerous ways to reduce its carbon footprint, identification and reduction of waste, particularly biohazard waste, will help to decrease the carbon footprint in the increasingly prominent endovascular realm.