The Leeds Teaching Hospitals NHS Trust

Leeds Teaching Hospitals NHS Trust crowned winners of the Green Surgery Challenge 2021

15 November 2021

An emergency and general surgery team from Leeds Teaching Hospitals NHS Trust has been crowned the winning team in a sustainable healthcare project.

Five surgical teams from across the UK were selected to compete in the Centre for Sustainable Healthcare's Green Surgery Challenge 2021 to work on projects that promote environmental and socially sustainable ways of practising.

Adam Peckham-Cooper, Consultant Emergency General Surgeon at Leeds Teaching Hospitals NHS Trust, said: "We were absolutely thrilled when the results were announced, especially given the calibre of the projects we were competing against.

"Our project focused on using a gasless procedure for laparoscopic appendectomy, by carrying out a real-time cadaveric study of a new device developed by the National Institute for Health Research (NIHR) Global Health Research Group for Surgical Technologies (GHRG-ST).

"The RAIS device mechanically creates a space within the abdomen to allow surgery to be carried out, rather than using medical gas, which is the largest contributor to the overall carbon footprint of the procedure."

The project is forecasted to save 110.3 tonnes of CO2e and £88,695 a year.

Green Surgery 2

Pictured L-R:  Tim Ho, Adam Peckham-Cooper & Lito Bautista

Aaron Quyn, Associate Clinical Professor of Surgery at LTHT said "We had a multidisciplinary team of talented individuals from clinical and engineering backgrounds exploring innovative ways we could reduce the carbon footprint of surgical procedures. In addition to the RIAS device, we were able to eliminate the unnecessary sterilisation of reusable surgical equipment and reduce the use of consumables, with the number of instruments per procedure reducing from 119 to 49.

"These "green trays" are now being used routinely during surgery, and we have also introduced reusable gowns and drapes and replaced urinary catheterisation with pre-induction toileting. It's amazing what results can be achieved when you review your everyday working practices. We really are delighted with the carbon savings, and we hope this best practice will be adopted by surgical teams worldwide."

The Green Surgery Challenge 2021 was an opportunity for the UK's surgical community to recognise the value of sustainable healthcare for surgical conditions and help the NHS meet its commitment to achieve net zero by 2040. It was created and delivered through collaboration with partners, including the Centre for Sustainable Healthcare, NIHR MedTech Co-operative in Surgical Technologies, Royal College of Surgeons England, Royal College of Surgeons Edinburgh, The Sustainable Healthcare Coalition, Brighton and Sussex Medical School and the Association for Perioperative Practice.

Green Surgery 1

 Pictured L-R: Katie Boag, Neil Mansfield, Arlene Roque & Aaron Quyn

Craige Richardson, Director of Estates and Facilities at LTHT said, "Approximately 5% of the UK's carbon emissions are health-related, and the Trust recognises the enormous challenge faced by climate change and the contributions our day to day activities make.

"Operating theatres contribute to this with energy requirements up to 6 times higher than other hospital areas. To meet our 2040 net zero target requires a huge team effort, so it's incredibly pleasing that our surgical team has been recognised for their innovative and sustainable practices."

This year, the Trust has also been nominated for the Net Zero Strategy of the Year award for its 'Green Plan - Sustainable healthcare the Leeds way'. The Green Plan is the central document for the Trust's sustainability agenda and it includes its objectives and an explanation of how they will be met.

Dr Olivia Bush, Programme Lead for Sustainable Clinical Practice at the Centre for Sustainable Healthcare, said: "Congratulations to the Leeds team on winning the Green Surgery Challenge 2021! The team made huge progress from having little awareness of the environmental impacts of surgery to being inspired by the challenge and transforming their appendectomy pathway into a highly impactful project.

"We know that to meet net zero, innovation is required, and the Leeds team used their innovative, gasless technique that saves medical carbon dioxide use for insufflation. This technique has the potential to be applied widely in abdominal surgery in the UK as well as globally, with the added benefit of improving access to surgery in low resource settings where medical carbon dioxide is not available.

"They also replaced single use instruments with reusable ones, which is a measure that needs to be adopted by all surgical teams nationwide, as reusables are known to reduce the carbon footprint of surgery and save money. The team upskilled quickly in carbon footprinting, which meant that they could clearly demonstrate the positive effect that their changes had made."

The Challenge has been made possible through the generosity of Gold Funders and Sponsors NIHR MedTech Co-operative in Surgical Technologies and Elemental Healthcare, Silver Sponsors Royal College of Surgeons England and Royal College of Surgeons Edinburgh, Bronze Sponsors the AHSN Network, Vanguard Medical Remanufacturing, and Bowa Medical UK. 

The team was led by Mr Adam Peckham-Cooper, Consultant Emergency General Surgeon and Honorary Senior Lecturer, Mr Aaron Quyn, Consultant General Surgeon, Associate Clinical Professor of Surgery, Deputy Director NIHR Surgical MedTech Co-operative.  The project team included Mr Noel Aruparayil, General Surgery Specialist Registrar, Honorary Research Fellow, Global Health Research Group-Surgical Technologies, Mr Thomas Pike, General Surgery Specialist Registrar, NIHR Clinical Lecturer, Dr Katie Boag, Emergency General Surgery Clinical Fellow, Dr Peter Culmer, Associate Professor in Healthcare Technologies, Engineering Lead NIHR Global Health Research Group-Surgical Technologies and Mr Tim Ho, Medical Student.