Lean and Green Surgery in Veterinary Practice: Strategies for Reducing Carbon Footprints in the Surgical Theatre

INTRODUCTION

Climate change stands as the most significant and critical threat to living beings in the 21^st century (Downey, 2023; Rojas-Rueda, 2025). It is estimated that health care’s climate footprint is equivalent to 4.4% of the global net emissions which is 2 gigatons of CO₂ equivalent . According to research carried out in the United Kingdom, the output of carbon dioxide (in terms of CO₂e) was estimated at 5.7 million metric tons only that year within the National Health Services (NHS) (Lenzen et al., 2020; Robinson et al., 2023). Likewise, the veterinary sector also contributes a significant carbon footprint in the environment. It is estimated that 5.7 gigatons CO₂ equivalent per annum is emitted by the ruminant supply chains representing about 80% of the livestock sector emissions, globally (Opio et al., 2013). Veterinary surgery itself emerges as a notable sector of resource consumption.

Several factors lead to this kind of carbon footprint sustainability including; the use of lightning-dependent procedures in conventional theatres, and equipment that cannot be optimized for effectiveness. A lot of waste is generated from the landfills when single-use instruments and supplies are thrown away. Still, other anesthesia gases are very responsible for this because they are so high in Global warming potential (GWP) (Koytcheva et al., 2021). Also, when it comes to labor rights in some surgical products’ supply chains, there are questions about ethics raised. Given these challenging situations, “sustainable surgery” is now a rising theme. The main thing in this kind of operation is to offer excellent veterinary services and adhere to professional ethics while reducing its environmental consequences at the same time. Sustainable surgery also contributes towards prudent utilization of resources, minimization of waste as well as eco-friendly substitutes whenever possible (Kwakye et al., 2011).

For this chapter, our attention will be directed toward specifics of how to minimize carbon emissions in veterinary surgical theaters, which will enable us to practice an eco-friendly kind of veterinary medicine. We will be covering a range of topics from maximizing energy efficiency and reducing waste production as well as implementing cutting-edge anesthetic techniques to help ensure veterinary practitioners have a better understanding of how they can make more environment-friendly choices while still taking care of their animals.

The adoption of eco-friendly practices in veterinary surgery is vital to the sustainability of the planet’s environment, securing a disease-free atmosphere for people and their animal friends. This chapter will serve as a valuable resource for veterinary professionals, students, and animal advocates alike, empowering them to become active participants in creating a more sustainable future for veterinary surgery (Green et al., 2011).

A green veterinary surgery doesn’t just care for animals well; it also minimizes its environmental footprints; renowned for a complete set of best clinical practices aimed at animal welfare in green settings. There is disposal of trash, resourcing as well and gas emission management strategies within the veterinary operations that lead to all these objectives starting from acknowledging the need to take this step to after-surgery care (Kwakye et al., 2011).

BARRIERS AND FACILITATORS TO IMPLEMENTATION

Despite the growing recognition of the importance of green veterinary surgery, several factors can hinder its large-scale adoption. Even though green veterinary surgery is a sound solution to help reduce the impact of the animal care system on the environment, its successful adoption requires a lot of attention. Sometimes those who do not have already used equipment may find themselves in situations where they cannot buy it (Pallari et al., 2021). Besides traditional practices and workflows in surgery are in such a way that veterinary professionals who are used to them may have difficulty in following through with it in case they need to apply them. Both animal healthcare providers and pet owners have a limited understanding as regards environmentally safe surgery, a knowledge gap that should be filled (Altwal et al., 2022). In some areas, the availability and cost of environmentally friendly options for operation equipment can affect their uptake. None of these difficulties are uncontrollable. Once these difficulties are recognized and cooperation is promoted within the veterinary family, answers may be found. If best practices could be shared, there could be advocacy for more sustainable research alternatives while promoting environmentally friendly veterinary green projects to create a path toward an era where ecological consciousness is combined with quality animal care (Azmal et al., 2014).

Overcoming the barriers

One has to take a variety of actions to get over them. Financial advantages such as state subsidies, tax privileges, or support from the sector may aid veterinary practice in covering the costs of the first outlay in going green. Workshops, training classes as well as advocacy events through education will prepare veterinarians with all the necessary information they need and relevant abilities so that green surgery can be put in place (Scheiterle et al., 2024). Innovation can be encouraged when veterinary associations, equipment manufacturers, and waste management companies are collaborating. By doing this, they get to come up with and implement the latest eco-friendly strategies meant for veterinary surgery needs. If done right educating people who own pets could just as well have a great impact on the high consumer demand among veterinary clinics and hospital practices that are environmentally friendly (Wyssusek et al., 2019).

Various forms of intervention, such as financing, learning, partnership, as well as awareness, can lead to the general embrace of environmentally friendly veterinary surgery meaning a safer earth for our pets. By addressing these barriers and promoting facilitators, the veterinary community can move towards a more sustainable future. Beyond the specific concerns raised in the studies above, veterinary surgery contributes to a broader environmental footprint in several key areas “reducing the need for surgical care, surgical care pathways, operating theatre energy and design, anesthesia, and products used in surgical care”. To prevent the need for surgery altogether, preventive healthcare, early disease detection, and responsible pet ownership are required (Bhutta & Rizan, 2024).

THE CARBON FOOTPRINT OF VETERINARY SURGERY

Energy Consumption

So far, our focus has remained on the human medical field, but the environmental implications of minimally invasive procedures in surgery cut across animal health too. Furthermore, like those in human medicine, veterinarians apply these procedures during different types of animal treatment such as spaying or neutering and complex orthopedic surgeries. This is how small animal practitioners contribute to the global greenhouse gas emissions from pet clinics and other health facilities. Let us now focus on the particular aspects of veterinary surgeries as sources of carbon dioxide (CO₂) emissions that contaminate our atmosphere (Cunha & Pellino, 2023).

The energy sources used in veterinary surgery include the following: the use of electricity in the conduct of surgeries, powering of equipment, cooling, and lighting among others. Thus, lighting and equipment constantly prove to be of great importance. Most of the clinics used normal sunlight lamps that are incandescent or fluorescent in style which has far lower efficiency than LEDs. These conventional bulbs, not only consume a lot of energy but also have a short lifespan and hence change frequently, thus contributing to pollution. Likewise, older surgical equipment are often larger and bulkier, and use much more power when in operation than newer models (Perry et al., 2023; Sullivan et al., 2023).

Temperature Control

Other factors include control of temperature, such that seepage and water fountains can be eliminated by regulating the temperature of water. Surgical areas require aseptic control, meaning that temperatures in operating rooms have to be precisely controlled, yet this has a price-energy demand. This report focuses on temperature control in Veterinary facilities because it plays an important role in the medical care of animals to help regulate their body temperatures to avoid incidences of infections among animal patients (Chan et al., 2023). Nonetheless, conventional HVAC systems can be problematic more research on other spaces means that finding ways of controlling the temperature of an operating room using options other than occupancy sensors, such as better insulation, can dramatically cut consumption. In these areas of energy consumption, there is room for improvement that, if achieved, would see veterinary practices move closer to achieving a greener surgical practice (Cunha & Pellino, 2023).

Waste Generation

Another major area in which veterinary surgery produces a lot of garbage is waste production and it contributes to the carbon footprint. Like their counterparts in human medicine, surgeries in veterinary medicine entail the extensive use of serviettes, garments, gowns, as well as other disposable surgical tools and accessories (Iepsen et al., 2024). That means, there is a lot of waste that is generated, particularly medical wastes which are mainly disposables. These objects cause a lot of greenhouse emissions and place a huge environmental burden on manufacturing, transportation, and disposal (Edra et al., 2017). Moreover, there would be an amplified effect of undertaking improper waste management practices. Failure to properly sort medical waste from other garbage means that medical waste mixes with normal trash hence it has to undergo complicated treatments using more energy. In addition, the choice of recycling facilities remains small amount for particular materials used in operations such as plastics, which adds to the challenges of managing surgical waste leading to increased landfilling and the production of methane, a greenhouse gas. Proper waste identification and separation, research for the use of substitutes, and recycling are possible solutions that can be implemented today by virtually any veterinary practice to substantially decrease the production of waste together with the carbon emissions arising from it (McLean et al., 2007).

Anesthetic Gases

About the use of anesthetic gases in treatment, it is quite essential to note that information concerning the carbon footprint in veterinary surgery is rather different from the one stated above. Some volatile agents used in animal surgeries have high global warming potential (GWP), and their usage contributes to climate change. Thus, they absorb and retain heat in the atmosphere to a greater extent than carbon dioxide and are a major factor in global warming once they are emitted into the atmosphere (Gadani & Vyas, 2011). Another factor contributing to environmental concerns is the threat of environmental contamination of waste anesthetic gas (WAG) and its disposal. If discharged directly into the environment of the surgery without undergoing appropriate WAG treatment in the filtration systems, then it did increase the carbon footprint of the surgery. Closed circuit anesthesia systems, proper disposal of WAG, minimized environmental impact, anesthetic vapor, and take back program ( Sherman et al., 2012; Douglas et al., 2023).

Surgeries and Their Carbon Footprint

Hospitals that treat animals are very important in the lives of animals since they help in treating them from time to time but the main issue is that they bear an immense carbon footprint leading to instability of the environment. A study on the environmental cost associated with the usage of veterinary products was carried out recently to measure the environmental cost of five typical veterinary procedures and what it discovered was alarming. Based on the foregoing results, it was revealed that the overall greenhouse gas emissions were different for the many types of surgeries performed with knee replacements being the most impactful, but there was a slight twist (Altwal et al., 2022). The average carbon footprint of the five procedures was mostly considerably high averagely, and it was similarly observed that merely 20-27% of the products accounted for 80% of the complete carbon footprint. This serves to identify primary areas of concern that can be addressed precisely within veterinary surgical practices to reduce their overall environmental responsibility. Reusable items are another problem area which are clothes, luxury items, combs, toys, and bibs. Surgical drapes and gowns utilized only once, gloves, and instrument packs all bear a major cost because of the environmental cost of manufacturing. These items usually involve complex manufacturing processes that demand a lot of resources and they usually call for commodities with some rigorous disposal procedures. But this is not the entire extent of the footprint. although reusable compared to disposables have environmental benefits, the procedures necessary for instrument sterilization take up resources as well thus contributing to environmental harm as well (Parker et al., 2024).

The impact of cleaning and sterilizing involves the energy used to heat water used during cleaning and sterilization and any waste that might come from discarded filters or cleaning solutions. Last but not least, sufficient medical waste disposal is necessary to avoid pollution of the environment and a risky concern that affects the lives of a population. However, each careful disposal cabinet has certain consequences for the external environment. Incineration and treatment of hospital waste consume energy and due to the space constraints in landfill disposal, there is a need for the development of such solutions (de’Angelis et al., 2023). Thus, these results stress the importance of creating methods that could assist veterinary practices in reducing the carbon impact of surgery, focusing on those facets that have a big influence as mentioned above. More specifically, by efforts to reduce precise many-use things, take more efficient sterilization of many-use knives; forks, and other instruments; and raising awareness of improved waste disposal system magnitude of veterinary operations may be minimized meaning that the effects they have on the environment would be greatly reduced (Rizan et al., 2023).

Minimal Invasive Surgery (MIS)

MIS has become a popular technique in surgical procedures as it provides an efficient way of delivering quality health care to patients with shorter hospital stays, less postoperative pain, and better aesthetic results. But when we look beyond the benefits accrued, these come at the cost of, larger accidental ecological injury (Chan et al., 2023). This is where MIS has developed the attraction of using specialized equipment and methods that prevent damage to tissues. Technique such as laparoscopic surgery involves making small incisions and use of a camera so that they can be able to have access to the areas where the operations are to be made, thus taking time to heal and are not hospitalized for longer periods. It is not limited to the aspects of the comfort of the patient, which evidence indicates carries a lower rate of infection and reduced post-surgical complication compared to traditional open surgery (Parker et al., 2024).

Thus, the very instruments, which provide such advantages contribute a lot to the general exertion put on the environment. Surgical gowns, face masks, gloves and gauze, disposable laparoscopic instruments, disposable laparoscopes, sterilized water, single-use drapes, and CO2 gas used in laparoscopic procedures contribute significantly to the waste carbon (Chamness, 2013). Producing these disposables is a costly and energy-wasteful process, and decomposing them can greatly stress landfill space and possibly harm the environment further. Moreover, as discussed above, operating rooms in particular are often energy consumers due to the need for constant lighting, ventilation, and function of sterilizers and other equipment in the course of the shift (Vasanthakumar, 2019).

Another concern with the use of CO₂ is environmental, being a byproduct of the gas used during laparoscopy. Although part of this gas is dissolved in the body and utilized by the body during surgery and recovery, the rest has been discharged into the atmosphere and contributed to GHG concentrations (Koytcheva et al., 2021). Pieces of literature from different authors comparing the carbon emissions of MIS with that of conventional surgery raise an outsourcing concern. The actual CO₂ emissions that are emitted when performing MIS procedures vary from cataract surgery that yielded 6 kg of CO₂ emissions to a highly resource-intensive robotic hysterectomy that will emit 814 kg of CO₂ emissions. This is approximately equivalent to the emission of carbon dioxide equivalent to driving a car for 2194 km for just one robotic hysterectomy (Power et al., 2012).

These burdens are not, however, limited to surgical waste only for they are far-reaching concerning the environment. Climate change caused by increasing concentrations of Green House Gases affects weather causing changes in precipitation patterns, leading to rising sea levels, and resulting in enhanced occurrence and severity of weather-related events (Douglas et al., 2023). This leads to a series of negative impacts on human health ranging from heat stroke, respiratory diseases, Acute Respiratory Infections, malnutrition, and many more which include epidemic diseases. The surgery aficionados, who reap the benefits from MIS today, may be shocked to become the customers of environmental negative effects of the same tomorrow. Thus, there is a need for some critical reflective analysis to be made of the practice within MIS with a view of counterbalancing its positive impact on the patients and the effects of some of the negative impacts that it has on the natural environment (Cunha & Pellino, 2023).

FINDING A SUSTAINABLE PATH FORWARD

Reducing the Carbon Footprint

The solution to this ethical dilemma does not involve a complete rejection of minimally invasive surgery. The advantages of such systems are beyond doubt when it comes to patient care. However, the goal here is to reduce the problematic effects of MIS on the environment while still maintaining the benefits (Chan et al., 2023). Fortunately, the increased interest in the bioavailability and environmental impact of surgical anesthesia agents does not necessarily signify bad news for the veterinary community, which might cut surgical CO₂ emission across a range of disciplines through a holistic effort that includes these important arenas. This chapter expands on these areas to offer actionable steps and methods for reducing a company’s environmental effects.

Laparoscopy and endoscopy are well-known examples of MIS that significantly improved veterinary medicine by providing various advantages for the animal patient. However, there are drawbacks of MIS techniques because they utilize sophisticated instruments and disposable tools hence increasing the rate of carbon footprint as compared with open surgery. More cautious policies may include, for instance, considering the applicability of open methods for less invasive operations or using reusable MIS instruments wherever possible will help to meet the objectives of providing quality patient care while not being detrimental to the environment (Forner et al., 2021).

Usually, the execution of effective energy-efficient lighting and equipment from operating rooms is possible to bring a positive change to the environment. LED lighting is approximately three or four times more efficient in terms of energy use than previous models available, and advanced surgical tools may include characteristics such as power management capabilities and an ability to turn off by themselves (Koytcheva et al., 2021). This paper aims to understand the choices made about anesthetic agents and the effect it has on the carbon footprint of surgeries. In a low-risk surgical environment, measuring regular WAG levels and replacing high GWP anesthetic agents with ones like Desflurane and Sevoflurane will greatly help the environment along with the implementation of a closed circuit system for the capture and then disposal of the WAG (Dormer et al., 2013; Douglas et al., 2023). Especially in today’s society eliminating the use of single-use items is extremely important. One can avoid generating waste where possible by using refusable instruments and supplies for future use and supporting enhanced recycling of non-recyclable or reusable materials that are used in health care provision (Sherman & McGain, 2016).

It is recommended that veterinary surgeons and related personnel consider the strategies which if effectively applied within the given key areas will enhance the welfare of the subjected animals as well as minimize the negative effects of surgery on the environment. Such a strategy of environmental commitment supports the well-being of the planet for the animal friends and generations to come.

The Path Towards Sustainable Veterinary Care

The sustainability of green veterinary care is possible when it embraces real-world concrete recommendations. Newer technologies such as the use of effective lighting that is energy efficient current surgical equipment also present lower energy usage in centers for veterinary services. Heating, ventilation, and air conditioning systems need to be checked frequently; also the systems need to be adapted to suit the climate in the particular building (Cunha & Pellino, 2023). In addition, decentralization of instruments also means that if we can use reusable ones whenever possible, then low usage, expulsion, and right sterilization would not only lessen waste production but could also lead to the prevention of vast sums of money over the years. Waste management plays an important role, and to ensure that there is efficient and proper handling of waste, a nucleonic waste management plan that involves segregation, recycling, and disposal is required (Bhutta & Rizan, 2024).

Veterinarians can look up to anesthesiologists and ask about a possible usage of the anesthetic agents with lower GWP which, in turn, reduces the environmental harm. Also, the expenditure involves waste gas scavenging systems, which employ the capture of an anesthetic gas that is exhaled during surgery operations to avoid emissions of the same to the air. Thus, by acting in the best interest of these strategies as well as the preferable, less expensive bringing of comfort and health for clients and their pets, veterinary practices can show their responsibility to people, pets, and lower generations and make the planet healthier to live in (Azmal et al., 2014).

Nonetheless, it cannot be denied that the environmental impact of veterinary surgery has been established; the silver lining is that this means there are plenty of ways to decrease this impact. That is why, a multi-pronged approach has been identified as being the most suitable to employ in this kind of situation. By reducing or avoiding such portion-controlled products like drapes and gowns, or by using instruments that can be reusable after proper sterilization and cleaning, the generation of waste would be greatly reduced. Housing, waste disposal, and recycling add to the layout of the sustainability of the overall healthcare facility and the segregation of wastes (McGain et al., 2009).

Mentioned above are the details of waste management; however, the benefits go an extra step in considering resource utilization in surgery. Professionals performing surgeries can ensure excess products and materials are not wasted and they can select energy-saving equipment. The use of standardized procedures to develop metrics for determining carbon footprint informs on suitable areas that need adjustment and prospects for change. Awareness among the vets is important and highly encouraging when coming up with programs about education and leadership to support green institutions (Bravo et al., 2023).

Sustainable veterinary surgery is not only limited to surgery theatres. By providing the most effective approach in terms of surgical process flow, while avoiding wastages on extra disposables, the two approaches reduce the harm to the environment. Energy, intelligent and natural lighting, and ventilation systems are essentially integral components operational in the operating theatre design. Anesthesia selection is wise to use agents resulting in little residual effect and utilize waste gas capture systems to collect expired gases. Last but not least, respect for the environment by using recyclable tools and responsibly sourced disposables where feasible, also predominates the provision of veterinary surgeries (Iepsen et al., 2024).

PRACTICAL STRATEGIES FOR REDUCING SURGICAL CARBON FOOTPRINT

Greening the Operating Room

The initial approach is to create efficiency to support the greening of the operating room. Transition to LED lighting reduces energy consumption by as much as 80%, in comparison to conventional sources. Modern surgical equipment with automatic cuts-off technology and a high rate of energy efficiency added to energy saving even in the use of equipment. In conclusion, the right position of the windows and the use of the light shelves increase the amount of natural light, meaning less artificial light is needed. These are positive measures that create a directional push toward the rationalization of the surgical ecosystem (Azmal et al., 2014).

Maintaining an appropriate level concerning the patient and ensuring that there is an accurate measure in controlling the fluctuation in temperature is indeed possible. Powered operating tables rotate at the right angle during surgery and modern HVAC systems with occupancy sensors are designed to detect occupancy in specific rooms such as an operating room and adjust the temperature accordingly to avoid wasting energy on unused operating rooms (Schiavone et al., 2022). Also, a particular emphasis must be placed on air renewal and only in exceptional cases it can be much higher than the normative recommended by energy saving standards. Such adjustments and check-ins help in attaining balance in terms of the safety of patients while at the same time achieving efficiency in energy consumption. It is possible to create a nice and sterile atmosphere to work for the surgeon and also not to neglect the ecology (Kwakye et al., 2011).

While upfront costs exist, the long-term economic and environmental benefits of solar panels are undeniable. This renewable energy source can significantly offset reliance on traditional grid electricity, leading to lower greenhouse gas emissions associated with surgery. In conclusion, minimizing the environmental impact of operating rooms requires a multi- pronged approach. Strategies like harnessing efficiency throughout the surgical suite, from lighting and equipment to temperature control, pave the way for a more sustainable future. Furthermore, exploring renewable energy sources like solar power offers a long-term solution for reducing the carbon footprint of veterinary surgery. By embracing these practical solutions, veterinary professionals can demonstrate their commitment to animal well-being while ensuring a healthier planet for generations to come (McGain et al., 2009).

Minimizing Waste in the Surgical Theatre

Evaluating factors that cause wastage in the surgical theatre, it is clear that there is a need to adopt a holistic approach to waste reduction. Moving from disposable instruments to reusables is thus the responsible thing in terms of the environment (McGain et al., 2009). Research has confirmed reusables that have been subjected to appropriate sterilization pose no threat to public health and are relatively better solutions to disposables because they are cost-effective in terms of the lifespan and are less emissive compared to single-use products. In addition, using surgical reusable drapes and gowns every time it is possible is also helpful in avoiding the disposal of materials unlike when using disposable surgical drapes or gowns (Kern-Allely et al., 2023).

Another important consideration most investors fail to pay adequate attention to is proper waste management. Physical waste management practices with well-defined induction procedures that involve appropriate disposal and recycling of specific commodities include the segregation of waste into bins of medical waste, paper, and plastics. The private players can also invest in recycling initiatives so that a significant fraction of surgical supplies that are discarded such as paper and cardboard can be rejuvenated (Sullivan et al., 2023).

Last but not least, waste reduction; particularly source reduction, has a significant role to play. Some of the ways that hospitals can avoid single-use plastic include; Other packaging materials such as recycled cardboard or biodegradable packaging material. There is also the opportunity to review the different surgeries to determine which is best suited for reusable equipment as well as other sustainable medical instruments, to reduce on use of disposable equipment. Implementing the aforementioned strategies thus reduces the amount of waste generated in operating rooms hence improving surgical teams' environmental impact (Bravo et al., 2023; Edra et al., 2017).

Greener Anesthesia

Greener anesthesia practices are key to minimizing the environmental impact of surgery (Smith, 2022). Anesthetic choice plays a significant role. Studies have shown that opting for anesthetic agents with a lower Global Warming Potential (GWP) can significantly reduce the environmental burden. Anesthesiologists can collaborate with surgeons to identify suitable low-GWP alternatives for each procedure. Beyond agent selection, minimizing waste anesthetic gas (WAG) emissions is crucial ( Sherman et al., 2012; Mishra et al., 2023). Traditional open circuit systems release WAG into the environment. Closed circuit systems, equipped with gas scavenging and rebreathing circuits, capture a significant portion of WAG, dramatically reducing emissions Looking towards the future, advocating for research and development of even more sustainable anesthetic options with even lower GWP is essential. By embracing these practices, surgical teams can contribute to a greener future for veterinary anesthesia (Viola et al., 2024).

CONCLUSION

Even though it is important to take care of animals, veterinary surgery pollutes the environment. Luckily, a better option may be realized as well. The following are some of the major necessities: energy-efficient operating rooms that make use of recyclable instruments and materials as much as possible; management of waste through the use of corresponding means. This is also possible with sustainable anesthesia techniques such as low-impact agents whose wastage can be minimized using gas capture methods. For animals and veterinary medicine to have a better future and a healthier planet, it will require people to collaborate consistently: this means sharing recommendations, encouraging green practices as well as pushing for other sustainable ways of doing things. This will guarantee that these partners’ goals are achieved - they will all work towards ensuring this planet is not only safe but healthy at the same time.