Environmental Impact of Adult Tonsillectomy: Life Cycle Assessment and Cost Comparison of Techniques.

Document Type

Article

Publication Date

7-8-2023

Publication Title

The Laryngoscope

Keywords

alaska; anchorage; environmental stewardship

Abstract

OBJECTIVES: To quantify and compare the cost and environmental impact of different techniques for adult tonsillectomy surgery, and to identify target areas for impact reduction.

METHODS: Fifteen consecutive adult tonsillectomy surgeries were prospectively randomized to one of three tonsillectomy techniques: cold, monopolar electrocautery, or low-temperature radiofrequency ablation (Coblation). Life cycle assessment was used to comprehensively evaluate the environmental impact of study surgeries. Outcomes assessed included multiple measures of environmental impact, including greenhouse gas (GHG) emissions, and cost. Environmental impact measures were analyzed to identify highest-yield areas for improvement, and outcomes were compared between surgical techniques using statistical analysis.

RESULTS: GHG emissions for cold, monopolar electrocautery, and Coblation techniques were 157.6, 184.5, and 204.7 kilograms of carbon dioxide equivalents (kgCO

CONCLUSION: Within the boundaries of operating room processes, cold technique minimizes cost and environmental impact of adult tonsillectomy surgery, with statistical significance noted in the impact of disposable surgical equipment. Areas of highest potential for improvement identified include reducing use of disposable equipment and collaboration with the Anesthesiology care team to streamline medication use.

LEVEL OF EVIDENCE: Level 2, randomized trial Laryngoscope, 2023.

Department

Otolaryngology

Department

Environmental Stewardship

Department

Surgery

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