¹Radboudumc, Nijmegen, Netherlands
²Evangelisches Krankenhaus Wesel, Wesel, Germany

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Introduction: Healthcare systems strive to protect public health. Yet, they are significant contributors to carbon emissions and waste [1]. While medical specialists are motivated to make their work more sustainable, they lack evidence on how to achieve this [2], [3]. This study aims to assess the environmental impact of a TVT operation, to compare CO₂ hotspots internationally and to identify mitigation strategies.

Methods: An observational life cycle assessment (LCA) was carried out in one Dutch and one German hospital. The primary outcome was the mean carbon footprint per TVT operation, measured in kilogram CO₂ equivalent (kg CO₂e). Secondary outcomes included identifying CO₂ hotspots for mitigation strategies in both countries. The LCA was performed according to ISO14040 guidelines and ReCiPe 2016 methodology.

Results: Two TVT operations were analysed per hospital. The mean carbon footprint per procedure was 67 kg CO₂ eq. and 42 Kg CO₂ eq. in the Netherlands and Germany respectively. The average operating time was 69 minutes in the Netherlands and 60 minutes in Germany. Disposables were the primary hotspot in both countries, contributing 37% and 44%, respectively. Additional key contributors in the Netherlands were patient transport (27%) and sterilization of surgical instruments (13%), while in Germany, sterilization of instruments (15%) and electricity usage (14%) played a significant role.

Conclusion: The carbon footprint of a TVT operation differs between countries, with a higher impact in the Netherlands. Country specific hotspots were patient transport in the Netherlands, and energy consumption due to grey energy mix in the German hospital. This knowledge supports targeted mitigation efforts.

Literatur

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[2] Cohen ES, Kouwenberg LHJA, Moody KS, Sperna Weiland NH, Kringos DS, Timmermans A, Hehenkamp WJK. Environmental sustainability in obstetrics and gynaecology: A systematic review. BJOG. 2024 Apr;131(5):555-567.
[3] Harris H, Bhutta MF, Rizan C. A survey of UK and Irish surgeons' attitudes, behaviours and barriers to change for environmental sustainability. Ann R Coll Surg Engl. 2021 Nov;103(10):725-729.