Sustainability of Laparoscopic Appendectomy. Variability of Determining Factors.

NCT07457853 | Completed

• 1 other identifier: DI20-0047
• Study Type: observational
• Target: 63
• Locations: 1 country
• Sites: 1

Brief Summary

Today, evidence shows that environmental changes significantly affect human health. The healthcare sector itself is a major emitter of environmental pollutants. It is responsible for 4-5% of global greenhouse gas emissions. The Declaration of Helsinki urges us to protect both human and planetary health, emphasizing the urgency of adopting strategies with a sustainable approach. Objective: To estimate the sustainability of laparoscopic surgery for acute appendicitis at Dr. Hernán Henríquez Aravena Hospital. Methodology: This is a quantitative observational study with a longitudinal analytical design. It will be conducted at Dr. Hernán Henríquez Aravena Hospital in Temuco, Chile. Data will be obtained prospectively through direct collection in the operating room and, when necessary, from the hospital database. Sustainability is defined in three dimensions. One dimension is economic; therefore, a cost analysis with an operational focus will be conducted. A social dimension will be considered, expressed in the clinical effectiveness of laparoscopic appendectomy in terms of DALYs (Disability-Adjusted Life Years). Finally, the environmental impact of laparoscopic appendectomies will be analyzed. To this end, an environmental impact study will be conducted in accordance with ISO 14040, using the CCALC database and OpenLCA software to estimate CO₂e emissions of greenhouse gases (GHG). The processes and products required to perform each appendectomy will be considered, from the moment the patient enters the operating room until their discharge. Analysis: Emissions from each surgery will be estimated. Factors such as surgical time, the number of operators involved, and the surgical and anesthetic resources used will be explored. The main result will be the calculation of the Environmental Impact-Effectiveness, considered as the average value. This will generate an indicator expressed in CO₂eq/Euros/average DALYs avoided. This indicator will allow it to describe variability in resource use during interventions, as well as the surgical intervention's carbon footprint and the costs per DALY (Disability-Adjusted Life Year) avoided. Results: Determination of the sustainability of each surgical procedure and identification of gaps or practices that can improve its sustainability. Development of a matrix of recommendations to improve the clinical sustainability of appendectomies.

Conditions

Sustainability

Keywords

Cost effectiveness; Life cycle assessment; Burden Disease; Sustainability; Laparoscopic appendicectomy

Outcome Measures

Primary Outcomes (1)

• Sustainability of laparoscopic appendectomy

  Sustainability of laparoscopic appendectomy will be calculates with the formula Costs/CO2eq/DALYs avoided. We will calculated the cost associated to laparoscopic appendectomy, the CO2eq and the DALYs avoided.

  1 year

Secondary Outcomes (3)

• Carbon footprint of appendectomy

  1 year

• Cost

  1 year

• Disability-Adjusted Life Years (DALYs) avoided

  1 year

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients undergoing laparoscopic surgery in acute appendicitis at the Hospital Dr. Hernán Henríquez Aravena in Temuco, Chile.

You may qualify if:

• Patients scheduled for laparoscopic surgical interventions for acute appendicitis.
• Participants must be over 18 years of age, competent, and able to easily understand the informed consent form and the characteristics of the study.
• Consent to participate

You may not qualify if:

• Other procedures or surgeries.

Sponsors & Collaborators

• Universidad de La Frontera: lead

Study Sites (1)

Hospital Hernán Henríquez Aravena

Temuco, Región de la Araucanía, 4814507, Chile

Location

Related Publications (10)

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  PMID: 30650330 BACKGROUND

• Eckelman MJ, Sherman JD. Estimated Global Disease Burden From US Health Care Sector Greenhouse Gas Emissions. Am J Public Health. 2018 Apr;108(S2):S120-S122. doi: 10.2105/AJPH.2017.303846. Epub 2017 Oct 26.

  PMID: 29072942 BACKGROUND

• Halonen JI, Erhola M, Furman E, Haahtela T, Jousilahti P, Barouki R, Bergman A, Billo NE, Fuller R, Haines A, Kogevinas M, Kolossa-Gehring M, Krauze K, Lanki T, Vicente JL, Messerli P, Nieuwenhuijsen M, Paloniemi R, Peters A, Posch KH, Timonen P, Vermeulen R, Virtanen SM, Bousquet J, Anto JM. A call for urgent action to safeguard our planet and our health in line with the helsinki declaration. Environ Res. 2021 Feb;193:110600. doi: 10.1016/j.envres.2020.110600. Epub 2020 Dec 9.

  PMID: 33307082 BACKGROUND

• Seifert C, Koep L, Wolf P, Guenther E. Life cycle assessment as decision support tool for environmental management in hospitals: A literature review. Health Care Manage Rev. 2021 Jan/Mar;46(1):12-24. doi: 10.1097/HMR.0000000000000248.

  PMID: 31116121 BACKGROUND

• Sherman JD, Thiel C, MacNeill A, Eckelman MJ, Dubrow R, Hopf H, et al. The Green Print: Advancement of Environmental Sustainability in Healthcare. Resources, Conservation and Recycling. 2020 Vol. 161:1-11. doi: 10.1016/j.resconrec.2020.104882.

  BACKGROUND

• Parvatker AG, Tunceroglu H, Sherman JD, Coish P, Anastas P, Zimmerman JB, et al. Cradle-to-Gate Greenhouse Gas Emissions for Twenty Anesthetic Active Pharmaceutical Ingredients Based on Process Scale-Up and Process Design Calculations. ACS Sustainable Chemistry and Engineering. 2019 Apr 1;7(7):6580-91.

  BACKGROUND

• Drew J, Christie SD, Tyedmers P, Smith-Forrester J, Rainham D. Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care. Environ Health Perspect. 2021 Jul;129(7):76001. doi: 10.1289/EHP8666. Epub 2021 Jul 12.

  PMID: 34251875 BACKGROUND

• Ferris M, Quan S, Kaplan BS, Molodecky N, Ball CG, Chernoff GW, Bhala N, Ghosh S, Dixon E, Ng S, Kaplan GG. The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies. Ann Surg. 2017 Aug;266(2):237-241. doi: 10.1097/SLA.0000000000002188.

  PMID: 28288060 BACKGROUND

• Jaschinski T, Mosch CG, Eikermann M, Neugebauer EA, Sauerland S. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2018 Nov 28;11(11):CD001546. doi: 10.1002/14651858.CD001546.pub4.

  PMID: 30484855 BACKGROUND

• https://www.healthdata.org/research-analysis/gbd.

  BACKGROUND

Study Officials

• Waldo Merino, Msc

  Universidad de La Frontera

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Msc, MD.

Study Record Dates

• First Submitted: January 21, 2026
• First Posted: March 9, 2026
• Study Start: August 30, 2024
• Primary Completion: June 1, 2025
• Study Completion: October 1, 2025
• Last Updated: March 9, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will share

Locations

CL (1)