Presented by: Victoria Jahrreiss MD
University Hospital Southampton NHS Trust, Southampton, UK; Department of Urology Medical University Vienna, Austria

Introduction

Considering ongoing concerns about sustainability and environmental impact, the discussion about the carbon footprint of single-use endoscopes compared to reusable scopes is highly relevant. There still is a lack of data on the environmental impact of single-use flexible cystoscopes. Therefore, the objective was to review the existing literature about carbon footprint of flexible cystoscopy and to analyse the environmental impact of the Isiris® (Coloplast) single-use flexible cystoscope compared to a reusable flexible cystoscope.

Materials

First, a systematic review on single-use and reusable cystoscope carbon footprint was performed according to the PRISMA statement. Secondly, carbon footprints of Isiris® single-use flexible cystoscope and reusable cystoscope were analysed and compared. 

Life cycle of the single-use flexible cystoscope was divided in 3 steps: Manufacturing, sterilization, and disposal, with several steps considered to estimate the carbon footprint over the life cycle: For each step, the carbon footprint values were collected and adapted from previous comparable published data on flexible ureteroscope.

Results

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The systematic literature review evidenced total carbon emissions within range of 2.06-2.41 kg CO2 per each use of single-use flexible cystoscope compared to a wide range of 0.53-4.23 kg CO2 per each case of reusable flexible cystoscope. The carbon footprint comparative analysis between Isiris® single-use flexible cystoscope and reusable cystoscope concluded in favour of the single-use cystoscope. Based on our calculation, the total carbon emissions for a reusable flexible cystoscope could be refined to an estimated range of 2.40 – 3.99 kg CO2 per case, depending on the endoscopic activity of the unit, and to 1.76 kg CO2 per case for Isiris® single-use cystoscope.

 

Conclusion

The systematic literature review demonstrated disparate results depending on the calculation method used for carbon footprint analysis. However, the results tend rather towards a lower environmental impact of single-use devices. In comparison to a reusable flexible cystoscope, Isiris® compared favourably in terms of carbon footprint

Funding

Calculations on carbon emissions for the Isiris® single use flexible cystoscope and reusable scopes were provided by Coloplast© Denmark.

Co-Authors

Pierre Sarrot,
Medical affairs department, Coloplast, Le Plessis-Robinson, France

Niall Davis, MD
Department of Urology, Beaumont Hospital and Royal College of Surgeons in Ireland

Bhaskar Somani, Professor
University Hospital Southampton NHS Trust