Environmental impact of minimally invasive procedures: life cycle assessment of two hospital care pathways

The healthcare sector significantly contributes to global environmental impacts, with minimally invasive procedures being particularly resource- and energy-intensive. This study at a Dutch tertiary hospital quantified the environmental impacts of two minimally invasive treatments in gynecology: total laparoscopic hysterectomy (surgical) and uterine artery embolization (non-surgical). Using comparative life cycle assessment, the study evaluated care pathways from outpatient appointments to follow-up, based on 40 waste inventories, considering material production, energy use, pharmaceutical production, sterilization, transport, waste disposal, and recycling. Hysterectomy generated 7.9 kg waste and 120 kg CO 2 -eq, while embolization produced 3.9 kg waste and 39 kg CO 2 -eq. Including hospitalization, total emissions were 215 kg CO 2 -eq for hysterectomy and 186 kg CO 2 -eq for embolization. Key environmental hotspots included patient and staff travel, electricity consumption for heating, ventilation and air conditioning, and single-use items. These findings highlight critical areas for reducing resource use and environmental impacts, advancing the transformation of healthcare systems toward more sustainable clinical practices.