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Leeds Teaching Hospitals Trust crowned winners of the Green Surgery Challenge 2021

Released on - 23/11/2021

Leeds Teaching Hospitals Trust crowned winners of the  Green Surgery Challenge 2021

The Green Surgery Challenge 2021 was an opportunity for the UK's surgical community to recognise the value of sustainable healthcare for surgical conditions and help the NHS meet its commitment to achieve net zero by 2040.

It was created and delivered through collaboration with partners, including the Centre for Sustainable Healthcare (CSH), the Association for Perioperative Practice (AfPP), NIHR MedTech Co-operative in Surgical Technologies, Royal College of Surgeons England (RCSEng), Royal College of Surgeons Edinburgh (RCSEd), The Sustainable Healthcare Coalition and Brighton and Sussex Medical School.

Dawn Stott, CEO at AfPP, said:

“We were delighted to play a part in such an important project. Clearly sustainability is going to play a key role in the future of perioperative care, and it is a key part of our work stream as an association.

“A recent survey we ran found 73% of respondents were already using reusable surgical instruments, but other innovations, like reusable gowns, were used far less frequently. The outcomes of the Green Surgery Challenge projects give us new ideas we can suggest to members enquiring about sustainability and could even form a starting point for standards and best practices in the future.

“This year we’ve also set up a new Sustainability Specialist Interest Group (SIG) to facilitate discussion of ideas and issues surrounding green surgery. Meeting sustainability targets in operating theatres is going to require a collaborative approach, we hope the Green Surgery Challenge 2021 is just the start of this.”

How did the Green Surgery Challenge work?

Five surgical teams from across the UK were selected to compete in the Green Surgery Challenge 2021. Each team was tasked to work on projects that promote environmental and socially sustainable ways of practising.

At a virtual conference and awards ceremony held on Thursday 4th November 2021, an emergency and general surgery team from Leeds Teaching Hospitals Trust (LTHT) were crowned the winning team in a sustainable healthcare project.

What was the winning project?

Adam Peckham-Cooper, Consultant Emergency General Surgeon at LTHT, said:

"Our project focused on using a gasless procedure for laparoscopic appendectomy, by carrying out a real-time cadaveric study of a new device developed by the National Institute for Health Research (NIHR) Global Health Research Group for Surgical Technologies (GHRG-ST).

"The RAIS device mechanically creates a space within the abdomen to allow surgery to be carried out, rather than using medical gas, which is the largest contributor to the overall carbon footprint of the procedure.

"We were absolutely thrilled when the results were announced, especially given the calibre of the projects we were competing against.”

The project is forecasted to save 110.3 tonnes of CO2e and £88,695 a year, equating to driving from G7 (Cornwall) to COP26 (Glasgow) 315,627 times.

Aaron Quyn, Associate Clinical Professor of Surgery at LTHT, said:

"We had a multidisciplinary team of talented individuals from clinical and engineering backgrounds exploring innovative ways we could reduce the carbon footprint of surgical procedures. In addition to the RIAS device, we were able to eliminate the unnecessary sterilisation of reusable surgical equipment and reduce the use of consumables, with the number of instruments per procedure reducing from 119 to 49.

"These "green trays" are now being used routinely during surgery, and we have also introduced reusable gowns and drapes and replaced urinary catheterisation with pre-induction toileting. It's amazing what results can be achieved when you review your everyday working practices. We really are delighted with the carbon savings, and we hope this best practice will be adopted by surgical teams worldwide."

Craige Richardson, Director of Estates and Facilities at LTHT, said:

"Approximately 5% of the UK's carbon emissions are health-related, and the Trust recognises the enormous challenge faced by climate change and the contributions our day-to-day activities make.

"Operating theatres contribute to this with energy requirements up to 6 times higher than other hospital areas. To meet our 2040 net zero target requires a huge team effort, so it's incredibly pleasing that our surgical team has been recognised for their innovative and sustainable practices."

About LTHT

Leeds Teaching Hospitals NHS Trust (LTHT) is one of the largest and busiest hospital trusts in the UK, providing healthcare and specialist services for people from Leeds, the Yorkshire and Humber region and beyond. They play an important role in the training and education of medical, nursing and dental students and are a centre for world-class research and pioneering new treatments.

This year, the Trust has also been nominated for the Net Zero Strategy of the Year award for its 'Green Plan - Sustainable healthcare the Leeds way'. The Green Plan is the central document for the Trust's sustainability agenda and it includes its objectives and an explanation of how they will be met.

Dr Olivia Bush, Programme Lead for Sustainable Clinical Practice at the CSH, said:

"Congratulations to the Leeds team on winning the Green Surgery Challenge 2021! The team made huge progress from having little awareness of the environmental impacts of surgery to being inspired by the challenge and transforming their appendectomy pathway into a highly impactful project.

"We know that to meet net zero, innovation is required, and the Leeds team used their innovative, gasless technique that saves medical carbon dioxide use for insufflation. This technique has the potential to be applied widely in abdominal surgery in the UK as well as globally, with the added benefit of improving access to surgery in low resource settings where medical carbon dioxide is not available.

"They also replaced single use instruments with reusable ones, which is a measure that needs to be adopted by all surgical teams nationwide, as reusables are known to reduce the carbon footprint of surgery and save money. The team upskilled quickly in carbon footprinting, which meant that they could clearly demonstrate the positive effect that their changes had made."

The Challenge has been made possible through the generosity of gold funders and sponsors NIHR MedTech Co-operative in Surgical Technologies and Elemental Healthcare, silver sponsors Royal College of Surgeons England and Royal College of Surgeons Edinburgh, bronze sponsors the AHSN Network, Vanguard Medical Remanufacturing, and Bowa Medical UK.

Tim Goodacre, Vice President, Royal College of Surgeons of England, said:

"It’s been exciting helping to judge these excellent examples of surgical teams taking on the challenge of climate change. The teams have been inventive and focused in their approaches to reducing the carbon footprint of operations. We are facing a climate emergency, and every sector needs to respond. The NHS is committed to achieve net zero carbon emissions by 2040, so we need to help spread these good ideas and continually look to improve further, if we are going to play our part."

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