Surgical Waste in the Urology or Suite: Laparoscopic vs Robotic Sacrocolpopexy

Objectives: Surgical procedures utilize a substantial number of single use items, leading to higher disposal costs and a considerable environmental footprint. OR waste is a key target to improving environmental sustainability. We sought to quantify and compare waste associated with single use and reusable surgical supplies in urology procedures, specifically in laparoscopic sacrocolpopexy (L-SCP) versus robotic sacrocolpopexy (R-SCP).

Methods: Retrospective chart review was conducted on patients who underwent L-SCP and R-SCP between August 2021-August 2023. Data collected included patient demographics, risk factors for pelvic organ prolapse, quantity of non-disposable surgical supplies (supplies that are sanitized and reused) and disposable supplies (single use supplies).

Results: 62 patients met inclusion criteria. An alpha level of 0.05 was used for all statistical tests, and Chi-square analysis for categorical variables and t-tests for continuous variables was used. No significant difference was noted between patient demographics. Mean OR time was significantly higher in L-SCP (383.5 minutes, CI [326.5, 440.5]) versus R-SCP (275.6 minutes, CI [259.5, 291.8]) = (p < 0.01). Mean total disposable supplies was higher in L-SCP (116.6, CI [95.4, 137.8]) versus R-SCP (84.8, CI [79.4, 90.2]) = (p < 0.01). There was no statistically significant difference between mean total non-disposable supplies between L-SCP and R-SCP.

Conclusions: Results illustrate significant differences in mean OR time and single use waste between L-SCP and R-SCP. Increased OR time and single use waste contributes to increased energy utilization and environmental waste. Further quantification of these results in terms of solid waste (kg) and carbon footprint (kgCO2-eq) may be necessary to appreciate true environmental impact. However, this study encourages further analysis of the environmental impact of other urologic surgeries.