Green-Gut Scoping Review — Environmental Impact of Robotic versus Laparoscopic Surgery.

Title: Environmental Impact of Robotic-Assisted versus Laparoscopic Surgery: A Rapid Scoping Review Objectives and Scope: This rapid scoping review maps the available evidence on the carbon footprint and environmental sustainability of robotic-assisted surgery (RAS) compared with laparoscopic and open surgery across all surgical specialties. It was conducted as Work Package 0 of the Green-Gut Study, a prospective life cycle assessment of robotic versus laparoscopic colorectal surgery funded through the NIHR Decarbonising Health and Social Care System programme. The review addresses four objectives: (a) to map existing quantitative evidence on the environmental impact of RAS; (b) to characterise the methodological approaches used, including system boundaries and data collection methods; (c) to identify specific limitations and evidence gaps in the existing literature; and (d) to confirm the rationale for prospective primary research in a UK NHS setting. Eligibility criteria required studies to report quantitative environmental impact data (carbon footprint in kgCO₂e, waste generation in kg, or energy consumption in kWh) for RAS compared with at least one other surgical modality. MEDLINE, Embase, and Web of Science were searched from inception to February 2026. JBI scoping review methodology was followed and reporting adheres to the PRISMA Extension for Scoping Reviews (PRISMA-ScR).