The carbon footprint of carpal tunnel release surgery in the United Kingdom

Research highlights

• "Prospective service evaluation of seven carpal tunnel release procedures in a standard model revealed that each procedure on average led to 28.8 kg (range 24.1–35.2) CO2 emissions."
• "Interestingly, re-sterilization of a generic hand set alone generated 14.1 kg of CO2 emissions accounting for around half of the total emissions. The disposable instruments and drapes accounted for another 9.3 kg of CO2 emissions."
• "Prospective evaluation of carbon footprint calculation of the lean and green model showed a reduction in carbon emissions to 6.6 kg (range 6.2–7.3)."
• "This project has demonstrated that a safe, efficient, sustainable and economical surgical practice in performing carpal tunnel release can be provided through a lean and green model. Further improvement in environmental and financial savings can be achieved by introducing greener patient pathways by moving carpal tunnel release outside the main operating rooms, bypassing ward admission process and using virtual follow-up. This model can be applied to other routinely performed hand surgical procedures by employing sustainable quality improvement principles."

Abstract

The primary aim of our study was to assess the environmental impact of moving from a standard to a lean and green model for a carpal tunnel decompression. We objectively measured the clinical waste generated, the number of single use items and the number of sterile instruments required for a standard procedure, and then moved to smaller instrument trays, smaller drapes and fewer disposables. These two models were compared for waste generation, financial costs and carbon footprint. Information prospectively collected on seven patients in the standard model and 103 patients in the lean and green model in two hospitals over a 15-month period, demonstrated a reduction in CO2 emissions of 80%, clinical waste reduction of 65%, and an average aggregate cost saving of 66%. The lean and green model can deliver a safe, efficient, cost-effective and sustainable service for patients undergoing carpal tunnel decompression.

Methods & Results

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Citation

Kodumuri P, Jesudason EP, Lees V. Reducing the carbon footprint in carpal tunnel surgery inside the operating room with a lean and green model: a comparative study. Journal of Hand Surgery (European Volume). 2023 May 24:17531934231176952.