Sustainability and Green Practices in the Neurosurgical Operating Room: A Scoping Literature Review

Background: The healthcare sector is a significant contributor to worldwide greenhouse gas emissions. The specific environmental impacts of neurosurgical operations remain largely unexplored. We sought to identify and review existing literature on sustainability and environmental impacts in the neurosurgical operating room, with an aim to assess scope and scale, and secondarily to evaluate potential interventions pertinent to neurosurgery. Methods: PubMed, Medline, and Scopus were searched for English-language articles published through July 2023 topically related to operating room sustainability practices and environmental impacts, with attention paid to neurosurgery. Results: A primary search identified 5 articles that specifically addressed sustainability issues within neurosurgery: 3 were observational studies, 1 was retrospective, and 1 was a prospective study. A further 12 studies (4 observational, 4 systematic reviews, 3 prospective, and 1 a survey on barriers to practice adoption) were evaluated to access the broader scope of environmental impacts of surgery that may be relatable to neurosurgery. Key reviewed subdomains included resource conservation, waste production, and carbon foot printing. Conclusions: A paucity of literature is available on sustainability practices within the field of neurosurgery. We identify the available evidence on the environmental impact of neurosurgical care and describe some avenues to reduce this impact by exploring surgical sustainability literature more broadly.