The carbon footprint of surgical operations: 2023–2025 systematic review update
4 affiliations
- 1Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Brescia, Italy
- 2Department of Orthopaedic Surgery, Ospedale di Gardone Val Trompia, Brescia, Italy
- 3Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Università degli Studi di Brescia, Brescia, Italy
- 4Department of Civil, Environmental, Architectural Engineering and Mathematics, Università degli Studi di Brescia, Brescia, Italy
Abstract
Surgical care significantly contributes to greenhouse gas emissions, with operating rooms consuming three to six times more energy than other departments relying heavily on single-use materials and anaesthetic gases. We conducted a systematic review of literature from 2023 to 2025 following PRISMA guidelines. The PubMed, Scopus and Healthcare LCA databases were searched, and eligibility criteria were applied. A total of 26 studies met inclusion criteria. Data were extracted on each study's scope and system boundaries, reported emission values, identified carbon hotspots, and any mitigation strategies evaluated. A structured quality assessment was conducted to evaluate the reliability of the included studies and to identify potential sources of bias. The included studies demonstrated wide variability in reported carbon footprints of surgery, ranging from under 5 kgCO₂e for minor procedures to over over 400 kgCO₂e for complex single-stage operations and approximately 1,000 kgCO₂e for whole multistage patient pathways. This systematic review underscores that surgical operations could have a significant carbon footprint, with emissions hotspots concentrated in consumable materials and energy consumption. It also reveals substantial variability and methodological heterogeneity in how surgical carbon footprints are calculated, pointing to the urgent need for standardized life-cycle based frameworks in surgical settings. Establishing common standards will enable more reliable benchmarking of surgical emissions and better comparisons across studies.
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BibTeX
@article{savio2026carbon,
title = {{The carbon footprint of surgical operations: 2023–2025 systematic review update}},
author = {Anna Savio and Beatrice Marchi and Andrea Roletto and Pierangelo Guizzi and Giuseppe Milano and Lucio Enrico Zavanella and Simone Zanoni},
journal = {PLoS ONE},
year = {2026},
month = may,
doi = {10.1371/journal.pone.0349415},
url = {https://doi.org/10.1371/journal.pone.0349415},
note = {CC BY},
}
RIS
TY - JOUR
TI - The carbon footprint of surgical operations: 2023–2025 systematic review update
AU - Anna Savio
AU - Beatrice Marchi
AU - Andrea Roletto
AU - Pierangelo Guizzi
AU - Giuseppe Milano
AU - Lucio Enrico Zavanella
AU - Simone Zanoni
PY - 2026
DA - 2026/05/18
JO - PLoS ONE
DO - 10.1371/journal.pone.0349415
UR - https://doi.org/10.1371/journal.pone.0349415
AB - Surgical care significantly contributes to greenhouse gas emissions, with operating rooms consuming three to six times more energy than other departments relying heavily on single-use materials and anaesthetic gases. We conducted a systematic review of literature from 2023 to 2025 following PRISMA guidelines. The PubMed, Scopus and Healthcare LCA databases were searched, and eligibility criteria were applied. A total of 26 studies met inclusion criteria. Data were extracted on each study's scope and system boundaries, reported emission values, identified carbon hotspots, and any mitigation strategies evaluated. A structured quality assessment was conducted to evaluate the reliability of the included studies and to identify potential sources of bias. The included studies demonstrated wide variability in reported carbon footprints of surgery, ranging from under 5 kgCO₂e for minor procedures to over over 400 kgCO₂e for complex single-stage operations and approximately 1,000 kgCO₂e for whole multistage patient pathways. This systematic review underscores that surgical operations could have a significant carbon footprint, with emissions hotspots concentrated in consumable materials and energy consumption. It also reveals substantial variability and methodological heterogeneity in how surgical carbon footprints are calculated, pointing to the urgent need for standardized life-cycle based frameworks in surgical settings. Establishing common standards will enable more reliable benchmarking of surgical emissions and better comparisons across studies.
SN - 1932-6203
ER -