DOI: 10.1093/bjs/znad258.042 ISSN:

553 Healing Patient, Harming Planet? Review of Waste Production and Recyclability of Surgical Instrument Packaging

Y K Lee, A Hariri, R Ghedia, T Tikka, D Kim
  • Surgery



In November 2022, the three UK Surgical Royal Colleges had issued an Intercollegiate Climate Emergency Declaration acknowledging that “climate change and anthropogenic environmental degradation pose a major threat to both human health and planetary health”. We reviewed the waste production and recyclability of surgical instrument packaging used in a common ENT procedure (thyroidectomy) and suggest strategies to improve surgical waste and make surgery more sustainable.


We prospectively audited packaging waste from 20 thyroidectomies performed at the Royal Marsden Hospital, UK between July and December 2022. All the packaging was weighted, categorised, and analysed after the operation. Recycling labels were recorded if present.


On average, each thyroidectomy produced packaging waste of 183 g (34%) of plain paper / cardboard, 167 g (31%) of soft plastic film, 142 g (26%) of laminated paper, 37 g (7%) of hard plastic and 11 g (2%) of metal foil. Of all packaging items we have collected, only one item had a recycling label.


Despite only one item of packaging having a recycling label, in its current form, 41% of the packaging we collected is easily recyclable. Product manufacturers should place clear labels on packing that can be recycled, switch to recyclable materials where possible and remove unnecessary information booklets that can be easily accessed digitally. Local waste audit and analysis can be the simple steps to make surgery more sustainable and reduce the environmental impact whilst treating patients.

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