Environmental Impact of Adult Tonsillectomy: Life Cycle Assessment and Cost Comparison of Techniques.
alaska; anchorage; environmental stewardship
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.
Meiklejohn, Duncan A; Khan, Zafrul H; Nuñez, Karyn M; Imhof, Lee; Osmani, Sabah; Benavidez, Amaris C; and Tarefder, Rafiqul, "Environmental Impact of Adult Tonsillectomy: Life Cycle Assessment and Cost Comparison of Techniques." (2023). Articles, Abstracts, and Reports. 7674.