THE PARADOX OF SURGICAL INNOVATION: CLINICAL BENEFITS AND ENVIRONMENTAL IMPACTS OF ROBOTIC AND LAPAROSCOPIC SURGERY
DOI:
https://doi.org/10.56238/arev7n12-278Keywords:
Robotic Surgery, Laparoscopy, Open Surgery, Environmental SustainabilityAbstract
Objective: To conduct a narrative literature review comparing open surgery (OS), laparoscopic surgery (LS), and robotic surgery (RS), analyzing their impacts on clinical outcomes (length of hospital stay and complication rates) and sustainability indicators (use of consumables, waste generation, and carbon influence – CO₂e). Methods: A literature search was performed in the MEDLINE/PubMed, Embase, Web of Science, and Cochrane Library databases, covering the period from 2015 to 2025, using descriptors related to robotic surgery, laparoscopy, open surgery, and environmental sustainability. A total of 11 articles were selected for analysis, including systematic reviews, meta-analyses, and comparative studies. Data extraction focused on clinical outcomes and quantification of carbon influence and waste production. Results: Robotic surgery (RS) was shown to be non-inferior to laparoscopic surgery (LS) in terms of morbidity and mortality, with advantages in complex procedures, such as lower conversion rates and shorter hospital stays in obese patients. However, both RS and LS, as minimally invasive techniques, were associated with significantly higher carbon footprints and greater waste generation compared with open surgery (OS), mainly due to the extensive use of disposable materials. Studies indicate that RS may have a carbon footprint up to 77% higher than OS and 38% higher than LS. Conclusion: Although minimally invasive surgery (LS and RS) provides important clinical benefits, its environmental impact is substantially greater. The adoption of sustainable practices, such as equipment reuse and optimized waste management, is essential for robotic and laparoscopic surgery to be consolidated as truly sustainable strategies within the modern hospital setting.
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References
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