ArticleSurgical endoscopy2026
Carbon footprint of disposable, hybrid, and reusable trocars in diverse hospital settings: a life cycle assessment.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
Funding
Abstract
backgroundTrocars are essential instruments in laparoscopic surgery, including high-volume procedures such as laparoscopic cholecystectomy. Although reusable trocars are generally assumed to be more environmentally sustainable than disposable or hybrid variants, previous life cycle assessments (LCAs) have relied on manufacturer-supplied data and rarely account for variation in hospital practices. This study provides the first LCA of disposable, hybrid, and reusable trocars based on independently verified material composition and multiple real-world clinical processing settings.
methodsA cradle-to-grave LCA was performed following ISO 14040/14044 standards. The material composition was determined by Fourier-transform infrared spectroscopy. The functional unit was defined as four trocars (2 × 5 mm, 2 × 12 mm) required for one laparoscopic cholecystectomy. Environmental impacts were evaluated across three hospital settings: an academic hospital with in-house sterilization, an academic hospital with outsourced sterilization, and a general hospital with in-house sterilization. Inventory data were derived from hospital-specific questionnaires, interviews, manufacturer contact, and published sources. Impacts were assessed using ReCiPe 2016 (hierarchical perspective).
resultsReusable trocars consistently showed the lowest carbon footprint across settings (0.33-0.94 kg CO
conclusionReusable trocars demonstrated the lowest environmental impact in most evaluated settings, outperforming disposable and hybrid alternatives. In certain settings, hybrid trocars also offered environmental advantages. Improving sterilization efficiency and expanding reuse-compatible device design can further reduce the environmental impact of laparoscopic surgery.
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