Carbon emissions in gastrointestinal endoscopy practice

BACKGROUND: Gastrointestinal endoscopy is acknowledged to have a considerable environmental footprint, driven by substantial greenhouse gas emissions and waste generation, yet it also presents opportunities for enhanced sustainability. OBJECTIVE: This review provides a comprehensive evaluation of the interventions currently feasible within existing endoscopy units, offering targeted recommendations to overcome identified barriers. METHODS: We systematically reviewed literature retrieved from PubMed, Google Scholar, and Web of Science using keywords: "green endoscopy", "sustainability", and "carbon footprint". RESULTS: Central to this effort is the early integration of Green Endoscopy principles into training, which can expedite the adoption of sustainable practices and ensure long-term success. Various measures that can be implemented to reduce carbon emissions are discussed. Furthermore, this review examines the transformative potential of the emerging digital landscape in promoting sustainable endoscopic practices, discussing the substantial environmental benefits that can be realized through the integration of artificial intelligence and the expansion of telemedicine. CONCLUSION: Ultimately, an optimized framework is proposed, emphasizing education, quantification and targeted improvements at systemic level to significantly reduce the carbon footprint of gastrointestinal endoscopy.