MTP4.05 Carbon footprint (carbon dioxide emissions resulting in an environmental impact) of the laparoscopic appendicectomy: a prospective observational study from a tertiary care NHS Trust hospital

Abstract Aims The objective of this study is to calculate the carbon footprint of the laparoscopic appendicectomy (LA) in grams of CO2 produced which results in an environmental impact. In addition, we also identify the biggest contributors to the carbon footprint and create a set of recommendations for CO2 emission reduction. Methods Carbon footprint related data was collected for using surgical equipment, electricity utilisation and consumption of CO2 used for the pneumoperitoneum, over 23 consecutive LAs. Peer-reviewed literature was used to determine the footprint of the equipment via a lifecycle assessment. The average carbon emissions for the pneumoperitoneum, theatre overheads (mainly HVAC – Heating Ventilation and Airconditioning) and electrical equipment was calculated. Results The average CO2 emission for an appendicectomy was 28258±1256 (24381-36267) grams. Variation was largely secondary to prolonged operations (spearman’s rank correlation coefficient 0.95) due to technical difficulties. Major contributors in carbon footprinting were pre-set (reusable items) 23 %, pre-set (disposable items) 40 %, theatre overheads (HVAC and lights) 16 %, CO2 pneumoperitoneum 9 %, scrubs and PPE 6 %, additional equipment 5 %, and utilisation of electrical equipment 1%. Conclusion The LA is a carbon costly procedure. CO2 emission from LAs may be reduced by switching over to reusable equipment and increasing operating room efficiency. The green theatre checklist provides excellent guidelines on this. More research is needed into less environmentally impactful gases to achieve a pneumoperitoneum.