12 Steps Toward Sustainability in Gynecologic Surgery.

Surgery is a major driver of climate change due to carbon emissions. Single-use materials and tools account for the largest environmental effects. In this Video 1 , we present 12 strategies to promote sustainability in the gynecology operating room, with a focus on minimizing single-use, disposable products: 1) reduce glove changes, 2) custom surgical packs, 3) reusable scrub caps, 4) avoid disposable energy devices, 5) stainless steel manipulators, 6) reusable suction irrigators, 7) alternatives to specimen-retrieval bags, 8) minimize single-use plastic trocars, 9) avoid advanced access platforms, 10) make the most of every suture, 11) use a laparoscope for cystoscopy, and 12) minimize red bag waste. Throughout the video, we present data to support our recommendations. Each of these strategies represents a small step, but, added together, they can make a big difference in our environmental effect as surgeons. A toolkit with additional resources is available in Appendix 1, available online at http://links.lww.com/AOG/E234 .