Understanding surgeons' preference for reusable surgical materials in laparoscopic surgery: A global cross-sectional survey

Making surgical practice more sustainable can substantially reduce healthcare's environmental impact, for example by adopting reusable surgical materials. However, a gap exists between surgeons' beliefs about the necessity to reduce this environmental impact and their adoption of reusable materials. This study examines psychological factors explaining surgeons' preference for reusable surgical materials in laparoscopic cholecystectomy, to inform strategies promoting sustainable practice. Secondary analyses were conducted using global survey data from 594 surgeons (Mage=45 years; 70.7% male) in 75 countries. Results showed that for trocars and surgical drapes, core explanatory variables for choosing reusable over disposable items are beliefs about personal responsibility for reducing surgical practice's environmental impact, whether changing towards sustainable surgical practice is perceived to be worth the strain on healthcare, and perceived collegial support. Preference for reusable clip applicators is statistically predicted by belief in surgical practice's need to reduce environmental impact, with other relevant variables varying by subsample. Preference for reusable gowns is predicted by beliefs about the need to reduce environmental impact, whether sustainable change is worth the strain, and perceived collegial support. Bayesian analysis showed extreme evidence for all models. These results provide stakeholders with concrete starting points to further examine interventions aimed at promoting sustainable surgical practice. In conclusion, strengthening perceived collegial support for change towards sustainable surgical practice could be a viable general strategy to strengthen surgeons' preference for reusable surgical materials. However, the relative importance of psychological factors differs by material, suggesting interventions tailored to specific materials will be most effective.