Surgical endoscopy · 2026
Surgical tray optimization: a prospective and survey-based evaluation of environmental and economic outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Eussen M M M, Brandwijk R M, Reising R C, Kimman M L, Nakhate P, van der Meer Y, Stobernack T, Bouvy N D
Аннотация
BACKGROUND: Operating rooms are resource-intensive environments. While reusable instruments are more sustainable than disposables, sterilization and reprocessing of unused instruments in the trays generate unnecessary environmental and financial burdens. Surgical tray optimization-removal of rarely used instruments-may reduce these impacts. Current evidence is fragmented, with no standard method to identify unused instruments and limited integration of environmental and cost analyses.
METHODS: We prospectively recorded instrument use for the Major General Surgery tray (94 reusable instruments) in one academic hospital in the Netherlands during 162 surgical procedures across multiple disciplines (November 2023-May 2024). Instruments used in < 20% of cases were considered for removal by (1) prospective clinical observation and (2) retrospective staff survey (surgeons, residents, scrub nurses). Life cycle assessment (LCA) and activity-based costing quantified the carbon footprint and costs.
RESULTS: On average, 19 instruments were used per case; 10 were never used. Observation-based optimization reduced tray size and weight by 54%, lowering costs by 55%. Survey-based review achieved smaller reductions (22% in number, 18% in weight, 21% in cost), with surgeons supporting more removals than scrub nurses. The original tray generated 1.25 kg CO2-eq per use. Optimization reduced emissions by 0.91 and 2.69%, corresponding to thresholds of < 10 and < 20% use, respectively.
CONCLUSION: In multi-specialty settings, tray optimization offers substantial cost savings and modest but cumulative environmental benefits. Clinical observation identified greater reductions than staff reviews. Combining LCA with cost analysis can provide a transparent framework to guide sustainable surgical practice.
METHODS: We prospectively recorded instrument use for the Major General Surgery tray (94 reusable instruments) in one academic hospital in the Netherlands during 162 surgical procedures across multiple disciplines (November 2023-May 2024). Instruments used in < 20% of cases were considered for removal by (1) prospective clinical observation and (2) retrospective staff survey (surgeons, residents, scrub nurses). Life cycle assessment (LCA) and activity-based costing quantified the carbon footprint and costs.
RESULTS: On average, 19 instruments were used per case; 10 were never used. Observation-based optimization reduced tray size and weight by 54%, lowering costs by 55%. Survey-based review achieved smaller reductions (22% in number, 18% in weight, 21% in cost), with surgeons supporting more removals than scrub nurses. The original tray generated 1.25 kg CO2-eq per use. Optimization reduced emissions by 0.91 and 2.69%, corresponding to thresholds of < 10 and < 20% use, respectively.
CONCLUSION: In multi-specialty settings, tray optimization offers substantial cost savings and modest but cumulative environmental benefits. Clinical observation identified greater reductions than staff reviews. Combining LCA with cost analysis can provide a transparent framework to guide sustainable surgical practice.