Environmental Sustainability: Waste Audit Comparison Operating Roomand In‐Office Laryngeal Surgery
Bibliographic record
Abstract
INTRODUCTION: With vast improvements in imaging and endoscopic technology, there has been a massive shift towards in office procedures for various laryngeal disorders with significant health system and patient benefits. Another benefit which has yet to be investigated is the potential environmental effects and waste reduction of in-office laryngeal procedures over traditional operating room surgery. OBJECTIVES: The purpose of this study is to perform a waste audit and compare the results between operating room and in-office laser laryngeal surgery. METHODS: Ten cases of in-office and operating room laser laryngeal surgery, performed for recurrent respiratory papillomatosis, were subjected to a waste audit with four waste streams identified. Recyclable, general waste, anesthesia source and sharps. All waste was included from the time of case preparation to termination. RESULTS: The cases were extremely homogeneous in the waste produced. The mean waste total produced for the operating room laser surgery was 2972 g of which 18% was recoverable/recyclable. Contamination rate was very low. Recycling was performed very well by nursing/prep staff; however, anesthesia was not recovering 13% of potential materials. The in-office waste produced was approximately one tenth of the operating room waste with almost all delegated into general waste. Potentially divertible/recyclable materials accounted for 38% of the waste in-office procedures. CONCLUSIONS: In-office laryngeal procedures produce 13% of waste compared to surgery performed for similar pathology. These procedures are cost effective, safe and have been demonstrated to enhance environmental sustainability. LEVEL OF EVIDENCE: NA Laryngoscope, 134:803-806, 2024.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".