Surgeons can confidently wear scrubs or white coats without impacting patient trust.

• Patients showed no significant difference in trust levels between surgeons in traditional attire (mean score 2.00) and those in scrubs (mean score 2.08).
• Trust scores were consistent regardless of physician attire across various patient demographics.

Surgeons can prioritize comfort and practicality in their attire while maintaining patient relationships.

Surgeons can improve access safety and efficiency with a novel manometric visualization technique for Veress needle entry.

• Pneumoperitoneum success rates were 99% across standard-weight patients with no complications in both test groups.
• The modified manometric technique reduced insufflation time to 1 minute, compared to 2 minutes with traditional methods (p < 0.001).

For obese patients, the four-forceps technique resulted in fewer failed entries (3% vs 15%) and reduced puncture attempts (median 1.0 vs 3.5, p = 0.019) without added complications.

These modifications enhance reliability and should be considered for diverse surgical populations.

Integrating environmental sustainability into operating room guidelines is feasible and necessary.

• Surgical practices significantly contribute to healthcare’s environmental impact, driven by disposables, energy use, and anesthetic emissions.
• A systematic review of 42 studies found the evidence quality was “very low” to “low,” yet consistent environmental threats were identified.

Surgical teams should consider actionable sustainability practices based on life cycle assessments to enhance both patient outcomes and reduce environmental footprints.

• Sustainability efforts could involve evaluating energy usage and transitioning to reusable materials where feasible.