Abstract
BACKGROUND AND OBJECTIVES: The objectives of this study were to determine carbon dioxide (CO(2)) emissions generated from nonreusable waste and compare across different types of hysterectomies for benign and malignant indications. Overall greenhouse gas emissions were not examined. METHODS: This is a prospective cohort study that identified women undergoing a robotic assisted, laparoscopic, vaginal, or abdominal hysterectomy for any indication. The amount of waste generated was collected for each case, along with patient demographics, and details of the procedure. Weight of waste was converted to kilograms of CO(2) emissions using the following formula: Carbon dioxide emissions = Waste in pounds × 1 Short ton/2000 pounds × Emission factor (kg CO2/short ton)× Global warming potential (GWP) We extrapolated the amount of CO(2) emissions produced to the number of hysterectomies performed annually in the United States. RESULTS: We found that robotic hysterectomies generated the highest mean CO(2) emissions (12.01 kg CO(2)), while vaginal hysterectomies produced the lowest mean CO(2) emissions of 4.48 kg (p < .0001).Our sample size of 100 hysterectomies was equivalent to 1099.4 kg CO(2) emissions. When our results were extrapolated, all hysterectomies in the United States produce 5.7 million kg of CO(2) emissions. This is equivalent to 234,513 airplane miles, and 95 trips cross-country across the USA from New York, New York to Los Angeles, California. CONCLUSION: Robotic hysterectomies generated a statistically significant majority of CO(2) emissions. Therefore, robotic surgery, as currently practiced, may offer a good initial opportunity for decreasing the carbon footprint of surgery.