Gastroenterology Today Winter 2023

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ADVERTORIAL FEATURE
GASTROENTEROLOGY TODAY – WINTER 2023
BUILDING DREAM
TEAMS IN GREEN
ENDOSCOPY
AN INTERVIEW WITH PROF. SEBASTIAN
Healthcare practitioners and industry members across the
world are thinking about how to mitigate the environmental
footprint of endoscopy. The modus operandi of the
entire endoscopy patient journey is being scrutinized
from evaluating appropriateness of the procedures, the
endoscopy room environment, the instruments that are
used during clinical procedures, to the equipment that is
employed in the reprocessing room.
The growth in society guidelines and position statements
on green endoscopy underlines this movement well.
For example, the European Society of Gastrointestinal
Endoscopy (ESGE) and European Society of
Gastroenterology and Endoscopy Nurses and Associates
(ESGENA) 1 published their position statement on reducing
the environmental footprint of gastrointestinal endoscopy.
The British Society of Gastroenterology (BSG), Joint
Accreditation Group (JAG) and Centre for Sustainable
Health (CSH) 2 also published a joint consensus on practical
measures for environmental sustainability in endoscopy.
Prof. Shaji Sebastian, Consultant Gastroenterologist, IBD
Unit, Hull University Teaching Hospitals, is the lead author
Prof. Sebastian discussed how to become sustainable in endoscopy with
Prof. Pohl and Prof. Bisschops, during the PENTAX Medical Hygiene Event.
of the BSG, JAG and CSH joint consensus. We recently
spoke with him about the `sustainable future` of endoscopy
and how to create green endoscopy dream teams.
What measures can endoscopy departments implement
to mitigate their environmental footprints?
There are many ‘low-hanging fruits’ that can minimize a
department’s environmental footprint. One of the most important
aspects is reducing unnecessary procedures, as the biggest
amount of waste in endoscopy is the procedure that was not
needed in the first place. The endoscopy services should have
better vetting procedures to determine the appropriateness of
an endoscopy. Additionally, rationalizing the use of endoscopic
biopsies and where possible using enhanced imaging techniques
to reduce the need for biopsies and adopting resect and discard
policies for diminutive polyps can be incorporated within the
endoscopy departments. One US study, analyzing whether biopsy
pots could be reduced or whether their size could be reduced,
found statistical improvement 3 . As practitioners, we must consider
how we can implement such findings across our endoscopy units.
Ambitious targets are being set by national health services
and ministries. What is essential in achieving this?
It is promising to see regulatory bodies set such ambitious targets.
For example, in the United Kingdom we have committed to net zero
by 2040 (Scope 1 and Scope 2 emissions). I fully embrace these
ambitions, as I believe if we don’t reach for the sky, we won’t get off
the ground. The only way we will achieve this is by working together.
We must collectively find sustainable alternatives that reduce the
impact of our endoscopic procedures.
Alongside this, practitioners must provide regulatory bodies with
information and guidance. We must publish practical guidelines,
even in areas where it may be difficult to obtain such evidence.
Think of infection risks, for example. These vary on a case-by-case
basis, which makes it difficult to establish significant findings. As
1
de Santiago ER, Dinis-Ribeiro M, Pohl H, et al. Reducing the environmental footprint of gastrointestinal endoscopy: European Society of gastrointestinal endoscopy
(ESGE) and European Society of gastroenterology and endoscopy nurses and associates (ESGENA) position statement. Endoscopy. 2022;54(08):797-826.
2
Sebastian S, Dhar A, Baddeley R, et al. Green endoscopy: British Society of Gastroenterology (BSG), Joint Accreditation Group (JAG) and Centre for
physicians, and reprocessing nurses, we must provide policymakers
with the right clinical evidence, so their legal expertise can guide us
towards the right decisions.
16 Sustainable Health (CSH) joint consensus on practical measures for environmental sustainability in endoscopy. Gut. 2023;72(1):12-26.
17
3
Gordon IO, Sherman JD, Leapman, M, et al. Life Cycle Greenhouse Gas Emissions of Gastrointestinal Biopsies in a Surgical Pathology Laboratory.
American Journal of Clinical Pathology. 2021; 156(4): 540-549.
Prof. Shaji Sebastian, Consultant
Gastroenterologist, IBD Unit, Hull
University Teaching Hospitals
Listen to the full dialogue:
Patients must be involved in this
as well. We see that they are
becoming more environmentally
aware and weighing up the
impacts of specific interventions.
Sometimes they are even okay
with trading off some of their
comfort, for example by using
slightly less nitrous oxide during
procedures. More and more
of these patients will enter our
hospital doors, and we must
involve them as informed partners
in decision-making.
Industry has a key role to play too mainly working with researchers
and endoscopy teams to come up with products and solutions
which are not only advancing the applications of endoscopy for
clinical care but also those that will support our green initiatives.
How can the field move forward as one?
A cultural change is happening as endoscopic units are
transforming themselves into green endoscopy dream teams.
Companies, such as PENTAX Medical, have sustainability high on
their agenda and are looking to minimize the environmental impact
of their solutions. Holistic thinking is being applied that spans from
supply chain to waste generation considerations, new society
guidelines that are being published and sustainable product design
principles that are being implemented.
Ultimately endoscopy needs to reinvent itself. We simply cannot
go back to business as usual; we need to be part of the solution,
not the problem. The key is for practitioners and industry to
work together, find solutions, and collaborate on this journey for
environmental sustainability. Pictures of our beautiful planet must
be kept in mind during these discussions, and together we must
act in the long-term interest of our children and future generations.
This is why we should care about green endoscopy.
The endoscopic field is embarking on a steadfast
sustainability transformation journey, whereby
systems-level thinking is prioritized. The entire
product development cycle is being reevaluated
and all aspects – from device design, to materials,
distribution and disposal – are being challenged.
Through innovation and collaboration, medical
solutions are increasingly coming to fruition that
minimize the environmental footprint of the field.
PENTAX Medical is a responsible medical devices’
manufacturer, committed to offering holistic hygiene
solutions that embody the “Power of Choice.” This
allows healthcare professionals to select a range
of options, including reusable, semi-disposable,
and single-use endoscopes aimed at optimizing
patient outcomes. By focusing on these core
elements, PENTAX Medical strives to establish new
benchmarks in hygiene, underlining its dedication to
patient safety and infection prevention in endoscopy.
The recently launched PENTAX Medical INSPIRA TM
video processor and AquaTYPHOON TM pre-cleaning
solution exemplify PENTAX Medical commitment
to ensuring environmental responsibility, while
delivering excellence in medical technology. The
video processor upgrades legacy endoscope
portfolios to the latest imaging standard, extending
the life cycle of each endoscope and providing
a future-proof platform for the next generation
medical solutions. Reversely, the AquaTYPHOON TM
revolutionizes pre-cleaning by eliminating
consumables, such as brushes or detergents, and
reducing water consumption by 70%–89% (evaluated
by internal tests against standard manual precleaning
procedures by PENTAX Medical). These
innovations, as well as many others, make PENTAX
Medical the partner of choice for practitioners that
are seeking to balance sustainability and hygiene in
their endoscopy suites.
Imprint:
PENTAX Europe GmbH,
Julius-Vosseler-Str. 104, 22527 Hamburg, Germany
W: https://www pentaxmedical.com
T: +49 40 561 92 0
E: info.emea@pentaxmedical.com
GASTROENTEROLOGY TODAY – WINTER 2023