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Presented by Royce Lee Characterizing the Burden of Intraoperative Urological Surgical Waste: Opportunities for Reduction and Mitigation R. Lee, A. Griggs-Demmin, A. Cohen Johns Hopkins University School of Medicine, Baltimore, MD, USA Introduction and Objective: In the US, each hospital patient produces about 15.33kg of waste daily, resulting in 5.5 million metric tons of waste every year. The burden of urologic surgical waste has not yet been fully examined. This study aimed to establish baseline estimates of the various types and amounts of intraoperative urological surgical waste, to understand the scope of the problem. Methods: Data from 31 cases among four surgeons at an urban academic center between July and September of 2021 were analyzed. Three waste streams were measured: regulated medical waste (RMW), normal solid waste (NSW), and laundered linens (LL). Data collection began when the OR team started preparing the room and ended when the team disposed of personal protective equipment. A waste catalog was recorded for each case. Results: The average 11.11kg and 0.97m^3?generated per case translated to 344.41kg and 30.05m^3?of total waste. Mass and volume of RMW, NSW, and LL were significantly different between case types, with robotic generating the most and endoscopic generating the least (Figure 1). One-way ANOVA was used to compare mean mass and volume of waste streams between case types. In all cases, there was improper disposal of non-RMW items as RMW. The average length of case, in minutes, was 98 for open, 201 for robot-assisted, and 55 for endoscopic. NSW accounted for 52.7% of total waste weight, RMW for 31.3%, and LL for 16.0%. Conclusions: The results demonstrate the excessive environmental and economic burden of urologic surgical waste, but also highlight opportunities for mitigation and reduction. These include proper waste segregation, better packaging of surgical equipment, and OR-based educational initiatives.