To quantitatively assess the environmental impact of a hospital-based digestive endoscopy unit, including waste production and water and electricity consumption, and to identify areas for improvement toward more sustainable practices.

This descriptive study was conducted in the Hepato-Gastroenterology Department “Medicine B” at Ibn Sina University Hospital over a 12-month period (January–December 2024). Data were collected retrospectively from endoscopy registries and included the number and type of procedures (diagnostic or therapeutic), number of biopsies, and use of disposable or reusable devices. Direct observation was used to measure the average amount of waste generated per procedure, sorted and weighed by category, and annual waste production was extrapolated accordingly. Water and electricity consumption related to endoscope reprocessing and endoscopy equipment were calculated.

A total of 1282 digestive endoscopic procedures were performed, including 1078 diagnostic procedures (509 upper endoscopies, 381 colonoscopies, 126 sigmoidoscopies, 62 endoscopic ultrasounds) and 204 therapeutic procedures (102 ERCPs, 39 dilations, 38 polypectomies, 17 argon plasma coagulations, 6 gastrostomies, 2 stent placements). A total of 704 biopsies were performed. Single-use devices represented the majority of the material used, including personal protective equipment, anesthesia consumables, endoscopic accessories (biopsy forceps, polypectomy snares, catheters, sphincterotomes), device packaging and waste generated during endoscope reprocessing. Annual waste production was 2734 kg (2.73 tons), ranging from 1.5 kg to 5 kg per procedure depending on procedure type. (Table 1) Water consumption for endoscope reprocessing was 64,100 L/year (≈50 L/procedure). Annual electricity consumption of endoscopy equipment (endoscopy tower, reprocessor, electrosurgical generators, room lighting) reached 3,575 kWh, corresponding to 1.95 tons of CO₂ emitted.

 Table 1: Waste generated by procedure type

These results confirm the substantial environmental footprint of digestive endoscopy, driven by extensive use of disposable devices and high resource consumption. Several improvement pathways emerge, including optimization of indications, reduction of unnecessary procedures, and limitation of non-essential biopsies through optical characterization and decision-support tools. The integration of innovative technologies, including artificial intelligence, and more efficient energy management (automatic standby systems, workflow planning) may contribute to a more sustainable endoscopy practice that balances diagnostic performance with environmental responsibility.