Rethinking Environmental Sustainability in the Operating Room: Beyond the Reusability Assumption for Surgical Instruments

Addressing the climate crisis is an urgent global priority, yet the healthcare sector continues to face significant challenges in implementing long-term green solutions. The sector accounts for 4.4% of global carbon emissions, with an even greater impact of 7% in the Netherlands. The latest Dutch report- Barometer Groene OK- proposes ten key measures to reduce the healthcare carbon footprint, including a shift from disposable to reusable materials. Although reusable instruments are often promoted as a sustainable alternative, their environmental impact within healthcare is contentious due to resource-intensive sterilization procedures. This critical commentary evaluates the environmental implications of reusable versus disposable surgical instruments, drawing on insights from the existing literature. Although further research is necessary, the initial findings suggest that, under current sterilization practices, disposable instruments may still have a lower environmental impact. At present, the assumption that reusable instruments are inherently more sustainable is overly simplistic. The adoption of sustainable packaging and the optimization of sterilization processes are essential steps to significantly reduce the carbon footprint of reusable instruments; however, these advancements may require several years to develop and to achieve widespread implementation. Switching prematurely to reusable surgical instruments can inadvertently increase the environmental footprint of the sector. Instead, a gradual transition - emphasising sustainable manufacturing of disposable instruments - alongside advances in sterilisation procedures - offers a more balanced and effective pathway toward sustainability in healthcare.