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Comparative Study
. 2024 Oct 7;73(11):1816-1822.
doi: 10.1136/gutjnl-2024-332293.

Environmental impact of single-use versus reusable gastroscopes

Mathieu Pioche  1 , Heiko Pohl  2 , João A Cunha Neves  3 , Arthur Laporte  4 , Mikael Mochet  5 , Jérôme Rivory  6   7 , Raphaelle Grau  8 , Jérémie Jacques  9   10 , Daniel Grinberg  8   11 , Mathilde Boube  12 , Robin Baddeley  13   14 , Pierre-Jean Cottinet  11 , Marion Schaefer  15 , Enrique Rodríguez de Santiago  16 , Arthur Berger  17 ; Sustainability Committee of French Endoscopy society (SFED)
Collaborators, Affiliations
Comparative Study

Environmental impact of single-use versus reusable gastroscopes

Mathieu Pioche et al. Gut. .

Abstract

Introduction: The environmental impact of endoscopy is a topic of growing interest. This study aimed to compare the carbon footprint of performing an esogastroduodenoscopy (EGD) with a reusable (RU) or with a single-use (SU) disposable gastroscope.

Methods: SU (Ambu aScope Gastro) and RU gastroscopes (Olympus, H190) were evaluated using life cycle assessment methodology (ISO 14040) including the manufacture, distribution, usage, reprocessing and disposal of the endoscope. Data were obtained from Edouard Herriot Hospital (Lyon, France) from April 2023 to February 2024. Primary outcome was the carbon footprint (measured in Kg CO2 equivalent) for both gastroscopes per examination. Secondary outcomes included other environmental impacts. A sensitivity analysis was performed to examine the impact of varying scenarios.

Results: Carbon footprint of SU and RU gastroscopes were 10.9 kg CO2 eq and 4.7 kg CO2 eq, respectively. The difference in carbon footprint equals one conventional car drive of 28 km or 6 days of CO2 emission of an average European household. Based on environmentally-extended input-output life cycle assessment, the estimated per-use carbon footprint of the endoscope stack and washer was 0.18 kg CO2 eq in SU strategy versus 0.56 kg CO2 eq in RU strategy. According to secondary outcomes, fossil eq depletion was 130 MJ (SU) and 60.9 MJ (RU) and water depletion for 6.2 m3 (SU) and 9.5 m3 (RU), respectively.

Conclusion: For one examination, SU gastroscope have a 2.5 times higher carbon footprint than RU ones. These data will help with the logistics and planning of an endoscopic service in relation to other economic and environmental factors.

Keywords: diagnostic and therapeutic endoscopy; endoscopy; environmental health.

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Conflict of interest statement

Competing interests: ERdS: Olympus Educational activity and advisory work, Apollo Endosurgery Educational activity, Norgine Conference fees and educational activity, Casen Conference fees. MP: Consultant for Olympus, trainer for Olympus, Pentax, Norgine, Boston, Cook. Other authors have nothing to disclose.

Figures

Figure 1
Figure 1. Diagram of the lifecycle analysis for reusable (A) and single used (B) scope.
Figure 2
Figure 2. Schematic representation of the different impacts of single use vs reusable endoscopes.
Figure 3
Figure 3. Impact on carbon footprint of the system, inflator and washer depending on the number of procedures performed per year considering a 10-year life expectancy of the system. Difference of impact represented in km (×10) travelled by the patient.
See this image and copyright information in PMC

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