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Could war and the supply chain crisis affect the sustainability of gastrointestinal endoscopy and single-use endoscopes?
  1. Andrea Sorge1,2,
  2. Gian Eugenio Tontini1,2,
  3. Lucia Scaramella1,
  4. Nicoletta Nandi1,2,
  5. Flaminia Cavallaro1,
  6. Maurizio Vecchi1,2,
  7. Luca Elli1,2
  1. 1 Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
  2. 2 Department of Pathophysiology and Transplantation, University of Milano, Milan, Italy
  1. Correspondence to Dr Luca Elli, Center for Prevention and Diagnosis of Celiac Disease-Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Lombardia, Italy; luca.elli{at}

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We read with great interest the article by Namburar et al. ‘Estimating the environmental impact of disposable endoscopic equipment and endoscopes’.1 The paper brilliantly investigates the environmental impact of gastrointestinal endoscopy, highlighting the large amount of waste generated, especially from disposable instruments. Transitioning to single-use endoscopes may reduce emissions from reprocessing but would increase net waste. Awareness of the need for sustainable development of the health sector is driving consideration of the ‘triple bottom line’ of the social, financial and environmental impacts of clinical practice.2 3 We want to emphasise that sustainability is a fluid concept. The three elements of the equation (environment, economy, society) are influenced by numerous factors. For example, availability and the price of resources and, as a …

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  • Contributors LE, GET, AS, LS, NN, FC and MV Concept, design, drafting and revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.