Strategy for net-zero carbon surgery

Lay summary Surgical care generates huge amounts of greenhouse gases, particularly in the operating theatre, owing to single-use medical equipment and choice of anaesthetic gases. To meet net-zero carbon in surgical services we need to support public health measures to reduce surgical disease, optimize surgical patient pathways and associated processes, and focus on operations with the greatest clinical benefit. Surgeons need to challenge the single-use culture, and shift to reusables across all settings, including operating theatres, emergency departments, and outpatients. This will require leadership, collaboration with supporting services and industry, research evidence, and education.