Urologie最新文献

Background: Single-use endoscopes have become widely established in urology. They are advocated due to the rapid integration of technological advances, the possibility of bypassing reprocessing requirements, and their potential to address gaps in availability. At the same time, their ecological impact in the context of sustainability is receiving increasing attention.

Objective: This article critically compares the advantages and disadvantages of single-use endoscopes versus reusable systems, with a particular focus on sustainability and resource consumption.

Materials and methods: Discussion of fundamental studies and expert recommendations, supplemented by comparisons with data from nonmedical sources on energy and material use as well as waste management.

Results: Production, packaging, and distribution of single-use endoscopes require considerable resources, since not only plastic elements but also electronic components, image sensors, and sterilization processes are involved. In contrast, reusable systems entail significantly higher consumption of water and chemicals during reprocessing. Evidence from other industries highlights the importance of closed-loop systems and recycling strategies, which are still scarcely implemented for single-use endoscopes.

Conclusion: Current data suggest that single-use endoscopes may have a worse impact on the environment compared to reusable endoscopes. However, current data do not yet allow for definitive conclusions. Further analyses are required to comprehensively assess resource and energy demands. Introduction of recycling strategies and reuse of particularly resource-intensive components represent promising approaches towards a more sustainable application of single-use endoscopes.

Background and objective of the study: Hospitals, especially surgical departments, are among the largest producers of waste in Germany. Data on waste management in the operating room (OR) are largely lacking. The aim of this study was to assess and discuss the possibilities of reducing waste and recovering recyclable materials in general surgery against the background of current practice.

Methodology: Surgical departments throughout Germany were surveyed on waste management. First, the theoretical waste separation possibilities for laparoscopic appendectomy were determined. Subsequently, a simple system for the separation of recyclables was established and practically tested in 35 operations. These were compared with 35 appendectomies without separation.

Results: Only 25.7% of hospitals perform waste separation. Theoretically, 20.7% of waste can be recycled, in practice up to 18.9%. Paper, cardboard and plastics, especially polyethylene terephthalate (PET) and high-density polyethylene (HDPE) were separated. This leads to a significant reduction in residual waste without extending the operation time.

Discussion: Separation of recyclables can contribute to more sustainable waste management in the OR. High-value recyclables can be recycled and the residual waste mass can be significantly reduced. This is possible without special effort and does not delay the processes in the OR. The opportunities for this have hardly been used in Germany to date.

The University of Ulm was founded in 1967. Except for the Department of Urology all other specialities of the existing municipal hospital joined the University Medical Center. At that time, the department of urology was-with > 250 beds-the world's largest urology department. There is conflicting historical data, but based on new information the first chairperson took office in July 1984. Initially the Department of Urology was a section of the Surgical Center, but it quickly attained the status of an independent University Urology Clinic. The clinic was a well-known transurethral resection of the prostate (TUR-P) center (Hösel, Marquardt), which evolved to include, among other things, an extracorporeal shock wave lithotripsy (ESWL) center and most notably an oncologic surgery, pioneering the development of the ileal neobladder (INB). The term "neobladder" was coined in Ulm. Large annual live surgeries and operative teaching seminars, and more than 100 visiting professors in Ulm popularized the INB technique and enhanced the clinic's reputation. Significant structural improvements included expanded operating capacity, which was facilitated by 4 operating rooms exclusively for the use of Department of Urology and a dedicated urology intensive care unit jointly managed by anesthesiologists and urologists. The staff of the department increased significantly with external reinforcement by senior physicians from other institutes, and ultimately 4 chairmen of renowned departments (Berlin, Charité, Munich, Klinikum rechts der Isar, Gainsville, Florida, USA, and Bangkok, Thailand) emerged from Ulm as well as numerous heads of national urology departments (e.g., in Karlsruhe, Kassel, and Wiesbaden).