Going Green in Gynecology: Decreasing the Carbon Footprint of Our Care

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This 2025 educational presentation by Dr. Alexandra Melnyk from the American Urogynecologic Society focuses on reducing the carbon footprint in gynecologic care by promoting sustainability in healthcare, particularly in urogynecology. The healthcare sector in the U.S. contributes approximately 10% of national and 4.5% of global greenhouse gas emissions and produces 5 million tons of waste annually, with operating rooms being particularly wasteful and energy-intensive.<br /><br />Key contributors to the operating room’s environmental impact include energy for temperature control, lighting, monitors, surgical equipment, and extensive use of single-use disposable items. Anesthesia gases like desflurane and nitrous oxide are potent greenhouse gases, while alternatives like propofol have much lower footprints. Life cycle assessments reveal that reusable instruments, such as stainless steel specula and the Pelosi uterine manipulator, have significantly lower carbon footprints and costs compared to disposable counterparts.<br /><br />Dr. Melnyk describes a "Green Draping Protocol" used in outpatient cystoscopy cases that reduces waste by 9.4% without increasing infection rates. Data shows no significant rise in postoperative urinary tract infections after implementing the protocol. Recommendations include reducing surgical supplies opened for minor or outpatient procedures and incentivizing manufacturing of reusable devices.<br /><br />The presentation advocates for systemic changes: urging the FDA to approve reprocessing of single-use devices, supporting sustainable manufacturing, and leveraging technology like AI judiciously to reduce environmental impacts. Individual and committee actions include updating surgical packs, choosing reusable supplies, switching to LED lights, telemedicine use, and educating staff and leadership about sustainability.<br /><br />The talk concludes by emphasizing collaboration across clinicians, industry, and regulators to “decarbonize the healthcare system,” aligning environmental responsibility with patient care through the "triple bottom line" approach — optimizing ecological, economic, and social outcomes.

Keywords

carbon footprint

sustainability in healthcare

urogynecology

greenhouse gas emissions

operating room waste

anesthesia gases

reusable medical instruments

Green Draping Protocol

FDA reprocessing approval

decarbonize healthcare