Green endoscopy

Gastrointestinal (GI) endoscopy significantly contributes to greenhouse gas (GHG) emissions and represents the third highest generator of waste in healthcare facilities. Main sources of carbon emission in endoscopy are the use of high-powered consumption devices, the heating and cooling of facilities, waste production mainly derived from the use of disposable devices, patient travel and the transportation of materials. The term “green endoscopy” refers to the practice of GI that aims to raise awareness, assess, and reduce endoscopy´s environmental impact. Strategies to reduce GHG emissions from endoscopy facilities include the careful evaluation of the indications for endoscopy and histology, the rationalisation of disposable devices, the careful management of personal protective equipment, the optimisation of energy use, proper waste disposal, and the use of telemedicine to reduce the environmental impact linked to the transport of patients for follow-up visits. Nevertheless, guidance on practical interventions to reduce GHG emissions in this setting are lacking. The aim of this review is to summarise the current data regarding the impact of endoscopy on GHG emissions and to highlight the possible strategies aimed at mitigating this phenomenon.