Healthcare systems are paying increasing attention to the environmental impact of care, including the resources used to produce, transport, use, reprocess and dispose of medical devices. In surgery, this has led to growing interest in how reusable and single-use instruments can contribute to more sustainable healthcare.
Reusability can play a role, but it is not appropriate for every device or every component. Clinical function, patient contact, materials, device design, reprocessing requirements and operating-room workflow can all influence whether a reusable, single-use or combined approach is appropriate.
Sustainable medical technology therefore involves more than replacing disposable products with reusable alternatives. It requires a broader view of how a device is designed, used and managed throughout its lifecycle.
Why Medical Device Sustainability Requires a Lifecycle View
Medical devices can have environmental impacts at different stages of their lifecycle, from materials and production to packaging, transportation, clinical use, reprocessing and eventual disposal.
Healthcare waste is one part of this picture. The World Health Organization identifies waste minimisation as an important priority and includes the use of reusable products, where safe and viable, among approaches that may help reduce healthcare waste.
However, a reusable device is not automatically more sustainable simply because it can be used more than once.
Single-use devices require a new device or component to be produced for each procedure. Reusable devices can spread the resources associated with producing a durable component across multiple procedures, but they also require repeated cleaning and, where applicable, sterilisation.
A 2025 systematic review found that reusable medical devices generally had lower carbon footprints in the studies reviewed, although results varied between devices and healthcare settings. For single-use devices, producing a new device for each procedure was often an important contributor to emissions. For reusable devices, repeated reprocessing contributed more to the overall environmental footprint.
This is why the environmental impact of a medical device needs to be considered across its full lifecycle rather than determined simply by whether it is reusable or single use.
Reusable or Single Use? Why the Answer Depends on the Device
Reusable and single-use surgical instruments both have important roles in healthcare.
Whether a device or component is suitable for repeated use depends partly on its design and materials.
The U.S. Food and Drug Administration (FDA) notes that design features such as narrow channels, hinges and other difficult-to-access areas can make effective cleaning more challenging. Materials used in reusable devices must also be compatible with the cleaning and sterilisation processes specified for the device.
Patient-contact requirements are another consideration. Surgical instruments that enter normally sterile tissue or the vascular system must be sterile when used. For reusable critical instruments, this generally requires appropriate cleaning followed by sterilisation before the device is used again.
Some devices or components may therefore be well suited to repeated use, while others may remain single-patient use because of their function, materials, design or reprocessing requirements.
The objective is not to make every device reusable. It is to determine where reuse is appropriate while maintaining the clinical, safety and practical requirements of the technology.
Where Reusable Surgical Instruments Can Reduce Resource Use
Where an instrument or component can be appropriately reprocessed and used repeatedly, the resources involved in producing that durable component can be spread across multiple procedures.
This can reduce the need to produce and discard an entirely new instrument for every case.
Studies comparing reusable and single-use surgical instruments have reported environmental advantages for reusable approaches in a number of settings, although results vary according to the device, procedure and reprocessing system.
A 2024 systematic review of minimally invasive procedures found that several of the more comprehensive lifecycle assessments reported lower environmental impacts for reusable instruments than for comparable single-use devices. The authors also noted that further research is needed to better understand how environmental impact relates to other considerations, including cost and clinical workflow.
These findings reinforce the importance of evaluating the specific device and how it is used rather than assuming that one approach will always have a lower environmental impact.
Reprocessing Is Part of Reusable Device Design
A reusable instrument must do more than withstand repeated use. It must also be capable of being appropriately cleaned, sterilised where required, inspected and maintained throughout its intended service life.
The FDA describes reusable-device reprocessing as a multistep process that begins with cleaning and may be followed by disinfection or sterilisation depending on the device and its intended use.
This means reprocessing needs to be considered when a reusable device is being developed.
The design of the device can influence how easily different surfaces can be accessed for cleaning. Materials need to tolerate the specified reprocessing conditions, and instructions need to clearly describe how the device should be prepared for subsequent use.
Healthcare facilities also need the appropriate equipment, processes and trained personnel to manage reusable instruments between procedures.
Reusability therefore depends not only on whether a device can physically be used again, but also on whether it can be appropriately reprocessed throughout its intended service life.
Sustainable Design Also Needs to Consider Operating-Room Workflow
Environmental considerations are only one part of medical-device design. Surgical technologies also have to fit into the practical workflow of the operating room.
Reusable and single-use components affect workflow in different ways.
Reusable components need to be collected, cleaned, inspected, sterilised where required, stored and returned to clinical use. Healthcare facilities may also need sufficient inventory to support procedures while other instruments are being reprocessed.
Single-patient-use components do not require reprocessing for another patient, which can simplify some steps between procedures, although they also require ongoing supply, packaging and disposal.
For this reason, workflow should not be treated as an automatic advantage of either reusable or single-use technology.
A more practical approach is to consider how different components are prepared, used, replaced, reprocessed or disposed of within the surgical pathway. These considerations can influence decisions about where reusable and single-patient-use elements are most appropriate within a device.
Combining Reusable and Single-Patient-Use Components
Reusable and single-use approaches do not always have to be treated as separate choices.
Some medical technologies combine both within the same system. Components that are suitable for repeated use can remain in service, while other components can remain single-patient use according to their function, patient-contact requirements or design.
This type of approach has also been examined in lifecycle research. One study of instruments used in laparoscopic cholecystectomy found that the hybrid instruments evaluated had a lower environmental impact than the single-use alternatives included in that study. The finding relates to those specific instruments and should not be assumed to apply to every hybrid medical device.
The broader principle is that different parts of a medical device can be considered individually rather than requiring the entire system to be either reusable or disposable.
Considering Sustainability and Workflow in Surgical Stapling
Powered surgical stapling provides one example of how reusable and single-patient-use components can be combined within one platform.
Reach Surgical’s iREACH IRIS powered stapler, which received CE Mark approval in 2026, uses a reusable handle together with components designed for single-patient use. Patient-contact components are single-patient use and therefore do not require reprocessing.
The stapler also uses a detachable power component, allowing the power source to be changed separately from the reusable handle.
This hybrid design illustrates how different elements of a surgical technology can be designed according to their individual requirements rather than applying the same reuse model to every component.
It also reflects a broader consideration in medical-device development: sustainability needs to be evaluated alongside clinical use, reprocessing requirements and operating-room workflow.
The environmental impact of any individual device or platform still needs to be assessed across its complete lifecycle and should not be inferred from the presence of reusable components alone.
Taking a Balanced Approach to More Sustainable Surgical Technology
There is no single approach to sustainability that is appropriate for every surgical instrument.
Reusable components can reduce repeated material use and waste where repeated use and reprocessing are appropriate. Single-patient-use components continue to have important roles where required by clinical function, materials, patient-contact considerations or practical workflow.
Technologies that combine reusable and single-patient-use elements provide another approach by allowing different components to be managed according to their individual requirements.
Sustainable healthcare therefore involves looking beyond whether a device is labelled reusable or single use. It requires consideration of the entire lifecycle of the technology, including how it is designed, used, reprocessed, managed within the operating room and handled at the end of its usable life.
Taking this broader view allows sustainability to be considered alongside the clinical, safety and operational requirements that remain central to surgical care.
References:
- World Health Organization. Health-care waste. Updated 2024.
- U.S. Food and Drug Administration. Reprocessing of Reusable Medical Devices.
- U.S. Food and Drug Administration. Factors Affecting Quality of Reprocessing.
- Centers for Disease Control and Prevention. Recommendations for Disinfection and Sterilization in Healthcare Facilities.
- Booth A, Chowaniec M, Goyal S, et al. The carbon footprints of single-use and reusable medical devices: a systematic review. BMJ Open. 2025;15:e108446.
- Martins RS, Salar H, Salar M, et al. Making minimally invasive procedures more sustainable: A systematic review comparing the environmental footprint of single-use versus multi-use instruments. World Journal of Surgery. 2024;48:2212–2223.
- Rizan C, Bhutta MF. Environmental impact and life cycle financial cost of hybrid (reusable/single-use) instruments versus single-use equivalents in laparoscopic cholecystectomy. Surgical Endoscopy. 2022;36:4067–4078.
This article is intended for general educational purposes and does not replace individual medical advice, diagnosis or treatment from a qualified healthcare professional.