Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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PloS one
The carbon footprint of surgical operations: 2023-2025 systematic review update
Surgical care significantly contributes to greenhouse gas emissions, with operating rooms consuming three to six times more energy than other departments relying heavily on single-use materials and anaesthetic gases. We conducted a systematic review of literature from 2023 to 2025 following PRISMA guidelines. The PubMed, Scopus and Healthcare LCA databases were searched, and eligibility criteria were applied. A total of 26 studies met inclusion criteria. Data were extracted on each study's scope and system boundaries, reported emission values, identified carbon hotspots, and any mitigation strategies evaluated. A structured quality assessment was conducted to evaluate the reliability of the included studies and to identify potential sources of bias. The included studies demonstrated wide variability in reported carbon footprints of surgery, ranging from under 5 kgCO₂e for minor procedures to over over 400 kgCO₂e for complex single-stage operations and approximately 1,000 kgCO₂e for whole multistage patient pathways. This systematic review underscores that surgical operations could have a significant carbon footprint, with emissions hotspots concentrated in consumable materials and energy consumption. It also reveals substantial variability and methodological heterogeneity in how surgical carbon footprints are calculated, pointing to the urgent need for standardized life-cycle based frameworks in surgical settings. Establishing common standards will enable more reliable benchmarking of surgical emissions and better comparisons across studies.
19 May 2026
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Diabetes-Technology and Waste: The Future is Now.
The downside of the success story of diabetes technology is the amount of waste generated by manufacturing and using such medical products. Quantitative surveys performed in the United States and Germany document how many pounds of plastic waste, batteries, and electronic parts are piling up per patient with diabetes each year; however, the actual environmental burden of diabetes care has not been assessed yet. Given the highly probable further increase in usage of diabetes technology devices, what are the options to change the situation? Ideally, one would avoid generating waste by optimizing the design of the products (Eco-Design); however, this approach faces a number of complex regulatory and economic hurdles. The issue of waste management is becoming increasingly important as the use of wearable devices increases. Stewardship of the environment will require all stakeholders to address waste management.
4 May 2026
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