Environmental footprint of open versus laparoscopic inguinal hernia repair

To compare the environmental impact of ambulatory inguinal hernia repair performed using open surgery versus laparoscopy through a life cycle assessment (LCA).

A descriptive, prospective, non-interventional study was conducted at Toulouse University Hospital between October 2024 and February 2025. Intraoperative consumption of materials, energy, and medical devices was prospectively recorded in real time. Environmental impacts were quantified using a comprehensive LCA covering the full life cycle of all products used. The two surgical approaches were compared across 16 environmental impact categories of which the 8 most contributive were analyzed in detail.

Laparoscopic repair was associated with a 1.44-fold higher environmental impact than open surgery, with an overall score of 4.67 x 10⁻³ versus 3.23 x 10⁻³, respectively. This difference corresponded to an additional 15.5 kg CO₂-equivalent emissions per procedure. Single-use non-woven materials and cotton-based products were the main contributors, whereas operating room energy consumption and sterilization of reusable devices contributed minimally.

In ambulatory inguinal hernia repair, the choice of surgical approach has a substantial influence on environmental impact, underscoring the importance of integrating environmental considerations into operative decision-making.