Last week, I performed a routine pediatric neurosurgical procedure that went exactly as planned. The patient did beautifully. The outcome was excellent. But afterward, I did something I don’t usually do; I photographed the waste bins.
What you see in these images is the aftermath of a single surgery. Mounds of blue surgical drapes, discarded instrument wrappers, plastic tubing, packaging upon packaging upon packaging.
One operation. One patient. One morning in the OR. The volume is staggering, and this scene repeats itself thousands of times daily across every hospital in America.
How We Got Here
The medical industry’s embrace of disposable plastics began with good intentions. In the 1960s and 70s, single-use items promised to eliminate cross-contamination risks and streamline hospital operations. No more labor-intensive sterilization of metal instruments. No concerns about inadequate cleaning between cases. Plastic was convenient, cheap, and seemingly harmless.
But we now understand what we didn’t know then: plastics don’t disappear. They fragment into microplastics that persist in our environment and accumulate in human tissue.
What the Research Shows
Recent research has detected microplastics in human blood, lungs, and placentas. Most alarmingly for my work, a 2025 study published in Nature Medicine found microplastics accumulating in human brains at concentrations higher than in any other organ, with levels increasing 50% over just eight years.
Research is increasingly linking plastic exposure to inflammatory responses, endocrine disruption, and neurodevelopmental effects. These are the very systems I work to protect in my young patients.
The Children’s Burden
When I operate on a child’s developing brain, I’m acutely aware that children face unique vulnerabilities. Their nervous systems are still forming, their blood-brain barriers are more permeable, and they have decades ahead to accumulate environmental exposures.
The plastics breaking down from today’s surgical waste will persist in the environment long enough to affect these same children throughout their lifetimes. Studies have linked microplastic exposure to oxidative stress, neuroinflammation, and synaptic dysfunction—mechanisms that could undermine the very neurological outcomes I’ve worked to preserve through surgery.
What’s Actually Necessary?
The sheer quantity of plastic in modern surgery often feels excessive. A single surgical gown comes wrapped in plastic. The sterile drapes covering the patient are plastic. The tubing, syringes, basins, suction devices, cautery pencils, light handle covers. Nearly everything within the sterile field is designed for one-time use.
I’m not arguing that all of this is unnecessary. Sterility and patient safety are non-negotiable. But I do question whether we’ve created a system that reflexively defaults to disposable without adequately evaluating alternatives.
Some items genuinely require single-use design for infection control, such as needles.
Yet many don’t.
The surgical instruments I use, including the delicate microscissors and forceps essential to neurosurgery are metal, reusable for hundreds if not thousands of cases. They are sterilized between cases without any compromise to safety.
We’ve proven that high-quality reusable equipment can meet the strictest sterility standards. So why has nearly everything else in the OR become disposable?
Why Change Is Hard
Part of the answer is institutional inertia. Hospitals have built entire supply chains around single-use products. Switching to reusable alternatives requires upfront investment in sterilization infrastructure and workflow redesign.
There’s also liability anxiety, the fear that reusable items might somehow increase infection risk, despite decades of safe use for surgical instruments. The cost of continuing down this path is becoming impossible to ignore. Beyond the environmental burden, we’re seeing emerging evidence that plastic pollution represents a genuine public health threat, particularly to the developing brains of children.
What Would Change Look Like?
It starts with honest evaluation. Every item in the surgical field should justify its disposability.
- Can this basin be steel instead of plastic?
- Can this drape be laundered rather than landfilled?
- Can manufacturers design packaging that doesn’t require four layers of plastic wrap?
Change also requires collaboration across disciplines, surgeons, hospital administrators, supply chain managers, and infection control specialists working together to identify opportunities for waste reduction without compromising care.
Looking Forward
When I look at these photos of surgical waste, I see both the challenge and an opportunity. We’ve created a system that prioritizes convenience, and it’s time to build one that prioritizes sustainability alongside safety.
My pediatric patients deserve both excellent surgical care and a livable future. These children, who will hopefully live for decades to come, will inherit a world shaped by the choices we make now. When microplastics from today’s discarded surgical supplies persist in the environment for centuries, potentially contributing to the very neurological conditions I treat, we’ve created a tragic irony.
Every bin of plastic waste is a reminder that our commitment to their health must extend beyond the operating room and into the broader environment that will shape their developing brains and bodies for decades to come.
We can do better. We must do better.
