OGBN P04 Laparoscopic Cholecystectomy- can we make it both Greener and cheaper?

Abstract Background Laparoscopic cholecystectomy is one of the most common operations in UK, with around 60,000 performed UK each year. Large numbers single use instruments are used laparoscopic surgery, despite availability reusable and hybrid alternatives. A instrument where but it also has a replaceable component Operating theatres major carbon hotspot within healthcare. The NHS alone estimated to be responsible for about 4% England's emissions, thought similar Scotland operating account up 33% solid waste produced hospitals. target reaching net zero emissions by 2040. There wide variability surgical between operators hospitals - our aim was examine what currently being 7 different hospital health board, suggest ‘greenest ’ possible tray. It already been shown that procedure, cost using clip appliers, scissors, ports 47% single-use equivalents, footprint 76% lower (Rizan 2021) Methods Visits sites performing board carried out 3rd Year medical Student, as part Sustainability Surgery SSC, during 4 week period May 2022. This snap shot audit only surgeon per site visited. items were recorded focus on reusable, tools. Costs supplier information gathered from theatre staff company representatives. relevant elements tray setups collated into table costs compared. CO2 when available. Results variation set ups same board. 3 no longer had any all use, rest combination disposable. All except ports- other ports. Most appliers- ties instead. 2 skin staples closure. No utilised sustainable option every item analysed. analysed below. Single cheaper than reusables nearly key more expensive long term. Hybrid or much emissions. Waste decontamination not taken this analysis. Conclusions Taking practises we visited, an ‘ideal setup’ environmental viewpoint devised available health-board. We adopted reduce both well costs. Where upfront purchasing new prohibitive, recommended. Addressing simple things such swapping low plastic their counterparts important often overlooked. Using end lifespan, efficient regular maintenance play role reducing impact Further work required healthcare sector manufacturers carry analyses commonly provide data upon which decisions could made improve sustainability allow meet its target.