Development of an Environmental Impact Calculator for Minimally Invasive Cholecystectomy: Protocol and Methodological Framework of the ECOMIS Project

Abstract

One of the greatest threats to public health in the 21st century is anthropogenic climate change. Healthcare services worldwide account for 4.9% of global CO2 emissions, with operating rooms being the most resource-intensive areas of the hospital. The need for environmentally sustainable change is a priority. Reliable quantitative data on emissions remain limited, which may hinder informed decision-making on surgical sustainability. The aim of this study is to develop and validate an easily accessible and user-friendly calculator to quantitatively estimate procedure-related carbon dioxide equivalent (CO2-eq) emissions of minimally invasive cholecystectomy across a range of countries, hospital volumes, and healthcare settings. The ECOMIS project follows a multiphase, stepwise design. The present study will focus on minimally invasive cholecystectomies. The calculator variables will be selected based on a systematic literature review of factors influencing CO2-eq emissions, with life cycle assessment (LCA) considered an established and comprehensive methodology for assessing CO2-eq emissions. The project will generate a comprehensive quantitative overview of the environmental impact associated with key variables involved in minimally invasive surgery. This tool has the potential to facilitate tailor-made and evidence-based decision-making and promote more sustainable surgical practices.