Life Cylce Assessment (LCA) for Different Minimal Invasive Surgical Techniques: A Comparison of Robotic vs . Laparoscopic vs Open Colorectal Operation and Identification of Most Effective Carbon Foot Print Reduction Targets.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Enrollment
- 30
- Locations
- 2
- Primary Endpoint
- Comparison of climate impact between robotic, laparoscopic and open colorectal procedures
Study Overview
Brief Summary
The goal of this study is to conduct a life cycle assessment of robotic, laparoscopic and open colorectal procedures and compare their climate impact. Further the investigators want to identify major targets for possible reduction in the CO2 footprint in colorectal procedures. The main questions are:
Researchers will identify used and prepared materials and instruments for the individual procedures and weigh them individually. SimaPro databases will help calculate the carbon footprints for the used instruments. Additionally, energy waste will be measured and carbon footprint of anesthesia will be estimated with previous existing data from other studies.
Detailed Description
Background Effective reduction of greenhouse gas (GHG) emissions as the key driver for climate change has to be the primary target of sustainable economics in the 21st century . The carbon footprint is calculated by the direct and indirect attributable GHGs emitted during a process, production cycle, or from an institution, such as a hospital.[1] The main metric for calculating the carbon footprint is the CO2 equivalent (CO2eq). In Switzerland, about 6-7% of all CO2 emissions come from the healthcare system. Most CO2 emissions come from hospitals, followed by medical treatments.
A large contributor to hospitals' carbon footprints are operating rooms. The high energy demand, anesthetics, and the production of single-use devices and instruments are significant climate-related hotspots in the operating field. However, the life cycle assessment (LCA) varies considerably based on factors such as the type and modality of the operation, among other variables. To date, only a few direct comparisons of the climate impact between surgical modalities, such as open, laparoscopic, and robot-assisted procedures, have been studied.
In this study, the investigators aim to compare the three modalities of visceral operations and their impact on the carbon footprint. As previously mentioned, a major component of the high GHG production in operating rooms is the high energy demand and needed resources. The best method to calculate the climate impact is the use of LCA.
Within an LCA, climate-related hotspots can be identified for each operation analyzed, which can provide possible ideas to reduce the carbon footprint of operating rooms and their impact on climate change.
Methods For this comparison, the investigators will conduct an LCA for each operation observed and compare it among the three different modalities: robotic, laparoscopic and open colorectal procedures.
Study Design
- Study Type
- Observational
- Observational Model
- Other
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Elective operations which are routinely performed robot-assisted, laparoscopic and open:
- •Only Colorectal procedures involving a bowel resection will be included (colectomies (right/left), anterior resections)
- •General anesthesia
- •Aged > 18 years
- •ASA classification from I to III
Exclusion Criteria
- •Procedures, which were uncompleted due to complications
- •Procedures, which switched modality (laparoscopic to open, robot-assisted to open)
- •Emergency procedures (mainly laparoscopic, unforeseen risk factors that lead to a change of modality, higher volume of used compressions and other materials).
- •Aged younger than 18
- •ASA classification > III
- •Vulnerable patient groups (pregnancy, patients with mental disability)
Outcomes
Primary Outcomes
Comparison of climate impact between robotic, laparoscopic and open colorectal procedures
Time Frame: 9 monts
Conduct an analysis of the climate impact of the three modalities of modern visceral operation and the standardized hospital days after the observed surgeries using LCA and the ReCiPe method. Compare the three modalities.
Secondary Outcomes
- Identify major targets for possible reduction in the CO2 footprint in visceral procedures.(9 months)