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@article{Adisa:2023:bjs/znad092,
author = {Adisa, A and Bahrami-Hessari, M and Bhangu, A and George, C and Ghosh, D and Glasbey, J and Haque, P and Ingabire, JCA and Kamarajah, SK and Kudrna, L and Ledda, V and Li, E and Lillywhite, R and Mittal, R and Nepogodiev, D and Ntirenganya, F and Picciochi, M and Simões, JFF and Booth, L and Elliot, R and Kennerton, AS and Pettigrove, KL and Pinney, L and Richard, H and Tottman, R and Wheatstone, P and Wolfenden, JWD and Smith, A and Sayed, AE and Goswami, AG and Malik, A and McLean, AL and Hassan, A and Nazimi, AJ and Aladna, A and Abdelgawad, A and Saed, A and Abdelmageed, A and Ghannam, A and Mahmoud, A and Alvi, A and Ismail, A and Adesunkanmi, A and Ebrahim, A and Al-Mallah, A and Alqallaf, A and Durrani, A and Gabr, A and Kirfi, AM and Altaf, A and Almutairi, A and Sabbagh, AJ and Ajiya, A and Haddud, A and Alnsour, AAM and Singh, A and Mittal, A and Semple, A and Adeniran, A and Negussie, A and Oladimeji, A and Muhammad, AB and Yassin, A and Gungor, A and Tarsitano, A and Soibih},
doi = {bjs/znad092},
journal = {British Journal of Surgery},
pages = {804--817},
title = {Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries},
url = {http://dx.doi.org/10.1093/bjs/znad092},
volume = {110},
year = {2023}
}

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TY  - JOUR
AB  - BackgroundHealthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.MethodsThis study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.ResultsIn phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.ConclusionThis is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.
AU  - Adisa,A
AU  - Bahrami-Hessari,M
AU  - Bhangu,A
AU  - George,C
AU  - Ghosh,D
AU  - Glasbey,J
AU  - Haque,P
AU  - Ingabire,JCA
AU  - Kamarajah,SK
AU  - Kudrna,L
AU  - Ledda,V
AU  - Li,E
AU  - Lillywhite,R
AU  - Mittal,R
AU  - Nepogodiev,D
AU  - Ntirenganya,F
AU  - Picciochi,M
AU  - Simões,JFF
AU  - Booth,L
AU  - Elliot,R
AU  - Kennerton,AS
AU  - Pettigrove,KL
AU  - Pinney,L
AU  - Richard,H
AU  - Tottman,R
AU  - Wheatstone,P
AU  - Wolfenden,JWD
AU  - Smith,A
AU  - Sayed,AE
AU  - Goswami,AG
AU  - Malik,A
AU  - McLean,AL
AU  - Hassan,A
AU  - Nazimi,AJ
AU  - Aladna,A
AU  - Abdelgawad,A
AU  - Saed,A
AU  - Abdelmageed,A
AU  - Ghannam,A
AU  - Mahmoud,A
AU  - Alvi,A
AU  - Ismail,A
AU  - Adesunkanmi,A
AU  - Ebrahim,A
AU  - Al-Mallah,A
AU  - Alqallaf,A
AU  - Durrani,A
AU  - Gabr,A
AU  - Kirfi,AM
AU  - Altaf,A
AU  - Almutairi,A
AU  - Sabbagh,AJ
AU  - Ajiya,A
AU  - Haddud,A
AU  - Alnsour,AAM
AU  - Singh,A
AU  - Mittal,A
AU  - Semple,A
AU  - Adeniran,A
AU  - Negussie,A
AU  - Oladimeji,A
AU  - Muhammad,AB
AU  - Yassin,A
AU  - Gungor,A
AU  - Tarsitano,A
AU  - Soibiharry,A
AU  - Dyas,A
AU  - Frankel,A
AU  - Peckham-Cooper,A
AU  - Truss,A
AU  - Issaka,A
AU  - Ads,AM
AU  - Aderogba,AA
AU  - Adeyeye,A
AU  - Ademuyiwa,A
AU  - Sleem,A
AU  - Papa,A
AU  - Cordova,A
AU  - Appiah-Kubi,A
AU  - Meead,A
AU  - Nacion,AJD
AU  - Michael,A
AU  - Forneris,AA
AU  - Duro,A
AU  - Gonzalez,AR
AU  - Altouny,A
AU  - Ghazal,A
AU  - Khalifa,A
AU  - Ozair,A
AU  - Quzli,A
AU  - Haddad,A
AU  - Othman,AF
AU  - Yahaya,AS
AU  - Elsherbiny,A
AU  - Nazer,A
AU  - Tarek,A
AU  - Abu-Zaid,A
AU  - Al-Nusairi,A
AU  - Azab,A
AU  - Elagili,A
DO  - bjs/znad092
EP  - 817
PY  - 2023///
SN  - 0007-1323
SP  - 804
TI  - Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
T2  - British Journal of Surgery
UR  - http://dx.doi.org/10.1093/bjs/znad092
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:001005722600001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://academic.oup.com/bjs/article/110/7/804/7133802
UR  - http://hdl.handle.net/10044/1/106700
VL  - 110
ER  -

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Dr George Garas BSc (Hons) MBBS (Dist) PhD DIC FRCS (ORL-HNS) FEBORL-HNS (Gold Medal)

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