Preprint Article Version 1 This version is not peer-reviewed

Think Global, Act Local: The Reduction of the Environmental Impact of Breast Surgery and the New Frontier of Green Surgery

Rebecca Allievi
* ,
Silvia Vicini
,
Chiara Bassetti
,
Marco Gipponi
,
Raquel Diaz
,
Letizia Cuniolo
,
Federica Murelli
,
Francesca Depaoli
,
Chiara Cornacchia
,
Cecilia Margarino
,
Chiara Boccardo
,
Marianna Pesce
,
Simonetta Franchelli
,
Maila Castellano
,
Marina Alloisio
,
Franco De Cian
,
Piero Fregatti
*
Version 1 : Received: 1 October 2024 / Approved: 1 October 2024 / Online: 1 October 2024 (15:42:31 CEST)

How to cite: Allievi, R.; Vicini, S.; Bassetti, C.; Gipponi, M.; Diaz, R.; Cuniolo, L.; Murelli, F.; Depaoli, F.; Cornacchia, C.; Margarino, C.; Boccardo, C.; Pesce, M.; Franchelli, S.; Castellano, M.; Alloisio, M.; De Cian, F.; Fregatti, P. Think Global, Act Local: The Reduction of the Environmental Impact of Breast Surgery and the New Frontier of Green Surgery. Preprints 2024, 2024100080. https://doi.org/10.20944/preprints202410.0080.v1 Allievi, R.; Vicini, S.; Bassetti, C.; Gipponi, M.; Diaz, R.; Cuniolo, L.; Murelli, F.; Depaoli, F.; Cornacchia, C.; Margarino, C.; Boccardo, C.; Pesce, M.; Franchelli, S.; Castellano, M.; Alloisio, M.; De Cian, F.; Fregatti, P. Think Global, Act Local: The Reduction of the Environmental Impact of Breast Surgery and the New Frontier of Green Surgery. Preprints 2024, 2024100080. https://doi.org/10.20944/preprints202410.0080.v1

Abstract

The impact of climate change is undeniable: considering the significant carbon footprint of surgical activity, there is an urgent need to pursue sustainability in the operating room as well. At the Breast Surgery Clinic of the IRCCS Ospedale Policlinico San Martino in Genoa, a prospective study was conducted from September 2023 to May 2024 to evaluate the effectiveness of a series of measures aimed at reducing the environmental impact in the operating room. 34 women affected by invasive breast cancer T1-2, cN0 underwent quadrantectomy and sentinel lymph node biopsy (SNLB): 17 according to a standard, high environmental impact approach; 17 according to a green approach based on the "5 R rule" (reduce, reuse, recycle, rethink, research). The implementation of measures such as the use of indocyanine green (ICG) for SNLB, the use of local anesthesia and intravenous sedation, the minimization of waste production, the use of reusable gowns, drapes and surgical instruments and the separate collection of non-infectious plastic waste resulted not only in a reduced environmental impact, but also in benefits for patients, who were spared a hospital admission the day before surgery, the administration of a radiotracer, and, in 58.8% of cases, an overnight stay. Considering the alarming data regarding the threat to our health, it is both possible and necessary to adopt virtuous behaviors in the operating room that reverse the current trend of emitting greenhouse gases.

Keywords

invasive breast cancer; environmental impact of breast surgery; environmental sustainability in breast surgery

Subject

Medicine and Pharmacology, Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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