Health Care Sustainability: Strategies for Operating Rooms and Urogynecologic Procedures

In 2023, the World Health Organization (WHO) concluded that climate change is the biggest threat to public health. Health care has a large carbon footprint with operating rooms contributing an inordinate amount to this issue. Surgeons have an opportunity to lead sustainability efforts by changing individual practices and collaborating with other stakeholders. Some of these changes that have been suggested include using reusable devices, including gowns, drapes, and specula; updating instrument trays and surgeon preference cards to minimize opening unused instruments; using clean energy sources where possible and adapting energy-saving options, including powering down operating room lights and heating, ventilation, and air conditioning (HVAC), turning off water faucets when not in use, and running decontamination equipment at capacity; educating staff on properly separating waste to reduce regulated medical waste and increase recyclables; and encouraging anesthesia colleagues to use regional anesthetic and intravenous propofol when appropriate. In addition to decreasing adverse environmental impact, many of these strategies result in significant cost savings. Ultimately, a culture change must occur where all health care professionals recognize and take responsibility for the significant and adverse effect that health care, most notably procedural and surgical care, has on the environment while balancing the potential effects to the health of our patients.