A new report published today by the Royal College of Surgeons in Ireland (RCSI) sets out a roadmap for reducing the carbon footprint of surgery in Ireland, while at the same time ensuring delivery of safe and effective surgical care.

Global Healthcare accounts for 12% of global greenhouse gas emissions. The surgical suite is a unique carbon hotspot within the hospital setting. It is three to six times more energy intensive than a clinical ward. 

The Sustainability Principles and Practice in Surgery document, produced by the RCSI Council Sub-Committee for Sustainable Surgery, chaired by Professor Camilla Carroll, reviews best practice and seeks to enhance the collective knowledge of surgeons and influence the behaviour of the whole surgical team towards delivering a leaner and low-carbon model of surgical care. 

Some of the key recommendations are: 

• Sustainable practice must become a core competency for all members of the multidisciplinary surgical team. 
• Establishing Green Teams and a Green Theatre Champion at each hospital site will facilitate implementation of the Green Theatre Checklist.  
• Education and training of healthcare staff in the principles and practice of delivering sustainable surgical care through programs endorsed by our professional bodies are required.  
• Graded reduction in reliance on single-use items in all surgical sub-specialties is essential.

In Ireland’s Climate Action Plan, the Health Service Executive (HSE) commits to achieving net-zero emissions by 2050. The Royal Colleges of Surgeons Intercollegiate Green Theatre Checklist acts as a template for implementation of sustainable practice in the operating room before, during and after surgery. RCSI recommends that this checklist is adopted within the Irish setting.   

Professor Laura Viani, RCSI President: “There is no part of human life that is not being affected by the impact of climate change. Healthcare and surgery are no different. It is vital that the surgical community understand the steps they can take towards environmental stewardship and mitigation against climate change. As surgeons we can take a leadership role in reducing our carbon footprint. I thank Professor Camilla Carroll for her leadership on this important work for RCSI and for healthcare in Ireland.” 
Professor Camilla Carroll, Chair of the RCSI Council Sub-Committee for Sustainable Surgery reminds us that “Climate change is the biggest health threat of the 21st century.

As surgeons we must be empowered through education and leadership to play our part in reducing the carbon footprint associated with the delivery of surgical care. I urge RCSI Members and Fellows and the wider surgical community to review this report and reflect on their own surgical practice and I would especially like to invite our “surgeons in training” to lead the way as our future “Green Surgery Champions”.  

The RCSI Sub-Committee on Sustainable Surgery was established by President Laura Viani in June 2022, reflecting the leadership role taken by RCSI in embracing UN Sustainable Development Goal 13 (taking urgent action to combatting climate change). 

RCSI is currently ranked first in the world for its contribution to UN Sustainable Development Goal 3, Good Health and Well-being, in the Times Higher Education (THE) University Impact Rankings 2023. It is committed to integrating the UN Sustainable Development Goals into its work. This is achieved in part by incorporating sustainability into its education programmes, ensuring its activities are environmentally responsible and by leveraging its role as leaders in health care to influence positive progress across the sector.