Kilograms of waste

More than 3.000 people work at the Faculty of Health, Medicine and Life Sciences. In 'Nice to meet you', these individuals introduce themselves and share their work within FHML. 

During her internships, Myrthe Eussen witnessed how much material was discarded in healthcare. Now, she is a PhD candidate working on the CAREFREE project at NUTRIM, which focuses on sustainability in the operating room. “During a half-hour gallbladder surgery, five to seven kilograms of waste is thrown away.” 

Myrthe studied medicine in Maastricht and has been working on her PhD in the Department of Surgery for over a year now. “After my bachelor's in medicine, I started doing research with professor Nicole Bouvy”, she explains. “At the end of my master's, I looked at options for a PhD. I knew Professor Bouvy was working on sustainability, which really interested me. In the final phase of my master's, I co-wrote the proposal for the CAREFREE project, so I was really involved in its creation. It kind of feels like my baby”, she laughs.

Sustainability 
The CAREFREE project focuses on the environmental impact of the operating room. “At least 25 per cent of waste produced in hospitals comes from the operating room”, Myrthe explains. “We are specifically looking at laparoscopic cholecystectomy, or the removal of the gallbladder via minimally invasive surgery. This is a common procedure. In the Netherlands alone, more than 25,000 of these surgeries are performed each year. Per procedure, five to seven kilograms of waste is generated, even though the operation only lasts half an hour on average.”

Sustainability is an important topic for Myrthe. “In my personal life, I try to live as sustainably as possible and make conscious choices. I am a vegetarian, and I try to avoid taking the airplane within Europe. During my internships, I saw how much material is used in healthcare. Then I realized I wanted to carry my personal motivation into my work as well. My hobby got a bit out of hand”, she laughs.

Trocars 
CAREFREE is divided into several components. “We looked at which measures have a high or a low impact on reducing CO2 emissions”, Myrthe explains. “Recycling has little impact, so we do not focus on that. ‘Refuse, reduce, and reuse’ have a significant impact. I focus on ‘refuse’. About ten percent of patients who undergo gallbladder surgery experience the same symptoms afterwards, so we want to better select patients and perform fewer surgeries.”

“I am also working on 'reuse' concerning material usage, since lots of items we use in the operating room are disposable”, she says. “We are particularly looking at trocars. These tubes are used to insert the instruments needed for surgery. Trocars are used not only in gallbladder surgeries, but in all types of minimally invasive surgeries. They come in both reusable and disposable forms. Many hospitals use the disposable variant, even though the reusable option is available.”

Fresh perspective 
Myrthe collaborates with people from various disciplines. “Our team is diverse and spread across the country. Besides Maastricht, the University of Amsterdam and Radboud University are involved. You can learn a lot from different disciplines. Not only in terms of research methods, but also because people who do not work in healthcare are involved. For us, what we do and use is all standard practice. Therefore, a fresh perspective from an outsider is valuable.”

CAREFREE officially started in January 2024. The project will run for six years. What does Myrthe hope to achieve by that time? “For my part of the project, I hope we have fully transitioned to reusable trocars in the Netherlands. I also hope we have developed a useful tool to guide and assist surgeons and patients in deciding whether to perform galbladder surgery or not.”

Want to learn more about CAREFREE? Myrthe Eussen discusses the project at the annual NUTRIM symposium on November 13 2024.

 Text: Joëlle van Wissen