Recycling in Ambulatory Gastrointestinal Endoscopy, a Single Center Experience

Am J Gastroenterol. 2025 Dec 1;120(12):2795-2799. doi: 10.14309/ajg.0000000000003538. Epub 2025 May 15.

Abstract

Introduction: Gastrointestinal endoscopy depends on high use of resources and is associated with significant production of waste. Recycling is one strategy that could decrease the carbon footprint from endoscopic activities and reduce landfill waste. Our aim was to assess the impact of recycling of endoscopic materials in a high-volume university outpatient ambulatory endoscopy center.

Methods: Three thousand sixty-three patients (1,253 M, 1,810 F) underwent gastrointestinal procedures over a 6-month period from January 15, 2024 to June 15, 2024. Endoscopy equipment consisting of cinch pad, gauze, lubricant gel packaging, sponge, suction valves, biopsy valve, air water cleaning adapter, water jet connector, suction tubing, plastic bowl, dual end brush, air/water bottle cap, and irrigation tubing were recycled after use. Data were collected through analysis of company invoices. Greenhouse gas avoidance was determined using United States Environmental Protection Agency Waste Reduction Model. The daily procedure volume and room turnover time were compared with a control group of 3,060 patients in the preceding 6 months.

Results: Total waste recycled equaled 1,708.4 kg, or 0.56 kg per procedure. In contrast to landfilling, recycling resulted in a net reduction of 4.42 metric tons of CO 2 equivalent. Compared with controls, volume per day increased (28.9 vs 24.3; P < 0.05), turnover time per patient decreased (18.2 vs 19.9 minutes; P < 0.05), and total regulated medical waste collected remained steady (3,007.9 vs 2,976.1 kg; P = 0.11).

Discussion: Recycling used endoscopy equipment is feasible, reduces the carbon footprint, and does not impede endoscopy unit efficiency.

Keywords: carbon; endoscopy; gastrointestinal; greenhouse; recycling.

MeSH terms

  • Carbon Footprint
  • Endoscopy, Gastrointestinal* / instrumentation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recycling* / methods