How can we address the ever-pressing need to 'green up' surgical practice in the National Health Service?

Clinical practice has inadvertently changed after the COVID-19 pandemic and currently the need to provide sustainable surgical services is more pressing than ever. The National Health Service has committed to a long-term efficient plan to reduce carbon footprint but there is no detailed plan for surgical practice, the domain that contributes the most to hospital-derived pollution. A series of consecutive steps and measures ought to be taken, starting from a hybrid approach quantifying surgically attributed carbon footprint. Then, a variety of suggested measures can be widely discussed and accordingly applied on a wider or more local level. Appropriate training should always precede implementing new practices to ensure that staff is familiar with these. These measures cover a broad range and should be arranged on a patient-centred basis from preoperative preconditioning to an effective follow-up. The need for more intense research and implementation of enhanced recovery protocols is widely discussed. Also, the necessity of green research and reinvestment of materials and resources is highlighted. A change of philosophy from a cradle-to-grave approach to a repurposing approach is suggested. We are confident that a new era is dawning in surgical practice and teamwork is the key for providing greener surgical services.

"Dissection Educational Videos" (DEVs) and their contribution in anatomy education: a students' perspective.

PURPOSE: The suspension imposed on Universities due to COVID-19 pandemic impeded students' educational opportunities. Alternative teaching modalities have been used. Substitution of dissection courses on cadavers was a great challenge. Present study investigates students' view on the efficacy of the "online" pre-recorded "dissection educational videos" (DEVs) in assisting anatomy teaching, aiming to modernize the lectures and reinforce comprehension. METHODS: The adequacy of the "online" anatomy courses and a possible new teaching modality were evaluated by the 2nd year pre-graduate students, employing an online questionnaire. RESULTS: One hundred and ninety-six volunteer students participated. Before the pandemic, 78.1% of the students constantly attended the "auditorium-based" lectures and 73% used self-teaching tools (STTs) for a better understanding of anatomy. During pandemic, a slight lower frequency (76%) attended the "online" lectures and a higher frequency (84.2%) used at least one STT. Up to 59.2% of the students disagreed with the permanent replacement of the "auditorium-based" by the "online" lectures, while 62.8% supported the idea of parallel conduction of the lectures. Combined teaching tools were the most preferred resources. 83.2% of the students stated that the dissection labs' cancellation negatively affected their education, and 75.5% supported the permanent addition of the pre-recorded DEV series in the lectures. CONCLUSIONS: COVID-19 pandemic created the temporary need for pure remote education. During lockdown, the use of STTs has significantly increased. A novel teaching modality (DEV series), presented in the study, can be used both as educational material and as a STT.