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Introducing team 2 of the Green Surgery Challenge

Vivien De Greef
Vivien De Greef • 5 October 2021

We are pleased to introduce the team from Leeds Teaching Hospital Trust NHS Trust who will be joining the Green Surgery Challenge Judging and Awards Ceremony November 4th as one of the finalists. Their project focused on modelling the use of an innovative, gasless laparoscopic procedure, eliminating unnecessary sterilization of reusable surgical equipment and reducing the unnecessary use of consumables. These approaches are examples of the third and fourth principles of sustainable clinical practice, ‘lean’ service delivery and low carbon alternatives to existing practices.   

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. 

The team carried out their project using the Sustainable Quality Improvement (SusQI) framework.  A holistic review of the laparoscopic appendicectomy process, carried out using a process map, revealed numerous opportunities to reduce the environmental impact.  The team implemented two key changes, modelled a third change and made plans for further improvements. 

The team listed all the instruments in the current procedure packs and were able to reduce these from 119 to 49, both reducing the number of trays of surgical instruments requiring sterilization and the number of single-use items opened but not used.  These ‘Green Trays’ are now begin used routinely. Patients are now also routinely being asked to pass urine before entering the anesthetic room to eliminate the need for urinary catheterization, reducing the use of consumables and potentially improving the patient experience. 

The team also modelled the change in resource use by using a gasless procedure for laparoscopic appendicectomy by carrying out a real-time cadaveric study, simulating the innovative surgical procedure.  The Leeds Global Health Research Group have developed a new device, RAIS (Retractor for Abdominal Insufflation-less Surgery) that mechanically creates a space within the abdomen to allow surgery to be carried out, rather than using insufflated gas.  The procedure was modelled using the standard procedure packs and the green tray, as well as further changes such as re-usable drapes and gowns. 

Learn more about their project, here

Join us at the free, online judging and awards ceremony to have an opportunity to hear valuable insights from the judging panel and find out more about each of the Green Surgery Challenge projects, including how much carbon was saved.

You’ll have the opportunity to meet the team to discuss their project in more depth, get top tips on how to carry out a similar project where you work and consider how this project could be spread and scaled nationally.  

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Stay tuned! Over the next two weeks, we will be sharing sneak previews of the other teams joining the Green Surgery Challenge judging and awards ceremony and the innovative projects they devised & implemented.

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