1220 ‘Tech’ Towards a Greener Future-the Impact and Benefits of Outpatient Bladder Cancer Management Using Next Generation Scopes and Lasers

Aim Bladder Cancer is the 11th most common cancer with 40,000 patients undergoing treatment per year within the UK in 2017. TURBT remains the gold standard, however a large subset of these patients such as low risk cancers, elderly, post BCG and anticoagulated patients. can be managed safely in an outpatient setting by incorporating next generation technology, transurethral laser ablation or resection (TULA). Outpatient management contributes to our National Get It Right First Time (GIRFT) and Greener NHS programs. The UK healthcare system accounts for4% of the UK’s carbon emission. With a net zero NHS Carbon aim by 2040, we evaluate the impact of our service towards these goals. Method A retrospective single centre data set from 2014-2021 was evaluated. Cost comparison of TULA and TURBT including Tariff, procedural times, theatre cost and bed savings was made. Results 598 patients underwent 1246 TULA procedures with similar recurrence rates to risk matched groups. The NHS costs for TURBT is £1,608 and TULA £979. The average UK procedure times for is 90 minutes and 30 minutes for TURBT and TULA respectively with theatre hourly costs at £940 for TURBT and £108 for TULA. An average hospital bed costs £222 per night with TURBT having an average in-patient stay of 1.6 days and TULA 0. Potential savings were calculated as £1,689,576 for procedural cost and £442,330 for hospital bed cost. Furthermore, the overall reduction in the equipment uses, waste, drug use etc. contributed to a decrease in carbon footprint by 14%. Conclusions Outpatient based bladder cancer management using TULA is a novel change which simplifies care with multifaceted financial benefit to our health care system and contributes to a reduced carbon footprint.