{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:15:16Z","timestamp":1788347716423,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sustainable healthcare is an evolving paradigm of growing importance that focuses on reducing environmental impact whilst maintaining quality patient care. Currently, evidence is lacking to support the use of sterile water in diagnostic colonoscopy resulting in a growing shift towards use of tap water and appropriate recycling of bottles. This single centre interventional study assessed patient outcomes, quantitative water use, cost and environmental benefits during colonoscopy when using filtered tap water for irrigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent a colonoscopy at this single centre in Melbourne, Australia over 3\u2009months were included consecutively. Trained endoscopy nursing staff prepared filtered, room temperature water for all diagnostic colonoscopy procedures during this time. Quantitative measurements of volume of water per procedure were recorded electronically. Peri\u2010procedural and post\u2010procedural complications were retrospectively audited 1\u2009month after the procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Complete patient data were collected on 133 patients between 1st February 2025 and 30th April 2025. No infective presentations\/complications were recorded. Five patient complications were noted: abdominal pain, intra\u2010operative atrial fibrillation, per\u2010rectal bleeding and constipation. Mean water use per colonoscopy was 205\u2009mL. The extrapolated\/calculated economic savings for the health service was $5000 per annum. Carbon Footprint saving 1.37\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      Eq per bottle saved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tap water use in endoscopy can be a safe, simple, economic alternative which promotes sustainable healthcare for the future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70557","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:39:32Z","timestamp":1774330772000},"page":"2174-2180","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Green Endoscopy: Can Filtered Water Use in Endoscopy Be a Safe, Economical Alternative Which Promotes Sustainable Healthcare?"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6741-7562","authenticated-orcid":false,"given":"Michael","family":"Rouse","sequence":"first","affiliation":[{"name":"Western Health  Melbourne Australia"},{"name":"University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Yuill","sequence":"additional","affiliation":[{"name":"Western Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Forbes","family":"McGain","sequence":"additional","affiliation":[{"name":"Western Health  Melbourne Australia"},{"name":"University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"McAlister","sequence":"additional","affiliation":[{"name":"University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"O'Shea","sequence":"additional","affiliation":[{"name":"University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7230-149X","authenticated-orcid":false,"given":"Justin M.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Western Health  Melbourne Australia"},{"name":"University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Faragher","sequence":"additional","affiliation":[{"name":"Western Health  Melbourne Australia"},{"name":"University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(20)30121-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1775873"},{"key":"e_1_2_10_4_1","unstructured":"Medicare Australia \u201cServices Australia\u2014Statistics\u2014Item Reports \u201d(2025 August 21st) https:\/\/medicarestatistics.humanservices.gov.au\/SASStoredProcess\/guest?_PROGRAM=SBIP%3A%2F%2FMETASERVER%2FShared+Data%2Fsasdata%2Fprod%2FVEA0032%2FSAS.StoredProcess%2Fstatistics%2Fmbs_item_standard_report&DRILL=ag&group=32084%2C32087%2C32222%2C32223%2C322."},{"key":"e_1_2_10_5_1","unstructured":"\u201cSTERIS Healthcare \u201d(Dec 2025) https:\/\/www.steris.com\/healthcare\/products\/endoscopy\u2010devices\/gi\u2010procedure\u2010products."},{"key":"e_1_2_10_6_1","unstructured":"T.KagiandG.Roberts \u201cMeaning of 1 kg CO2\u2010eq Emissions | Carbotech [Internet]. Carbotech \u201d(2018) https:\/\/carbotech.ch\/en\/projekte\/die\u2010bedeutung\u2010von\u20101\u2010kg\u2010co2eq\u2010emissionen\/."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.70054"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2024.06.031"},{"issue":"2","key":"e_1_2_10_9_1","first-page":"178","article-title":"How to Increase Proximal Adenoma Detection Rate: A Meta\u2010Analysis Comparing Water Exchange, Water Immersion and Air\/CO2 Insufflation Methods for Colonoscopy","volume":"33","author":"Aziz M.","year":"2020","journal-title":"Annals of Gastroenterology"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2024.05.003"},{"key":"e_1_2_10_11_1","volume-title":"Australian Drinking Water Guidelines Paper 6 National Water Quality Management Strategy","author":"NHMRC, NRMMC","year":"2011"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41545\u2010022\u201000174\u20101"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.09.048"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0196\u20106553(96)90031\u20100"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001610\u2010199711000\u201000003"},{"issue":"5","key":"e_1_2_10_16_1","article-title":"Ripple Effect: Safety, Cost, and Environmental Concerns of Using Sterile Water in Endoscopy","volume":"4","author":"Agarwal D.","year":"2025","journal-title":"Climate Change in Digestive Health and Disease"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70557","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70557","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70557","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:34:11Z","timestamp":1788345251000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70557"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,23]]},"references-count":15,"journal-issue":{"issue":"7-8","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/ans.70557"],"URL":"https:\/\/doi.org\/10.1111\/ans.70557","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,23]]},"assertion":[{"value":"2026-01-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}