Penggunaan alat medis sekali pakai seperti Harmonic Scalpel pada prosedur laparoskopi berkontribusi terhadap peningkatan biaya operasional serta timbulan limbah medis, sehingga diperlukan pendekatan alternatif melalui proses ulang (reprocessing) yang perlu dievaluasi secara komprehensif dari aspek keberlanjutan. Penelitian ini bertujuan menganalisis keberlanjutan proses ulang Harmonic Scalpel di Rumah Sakit Xberdasarkan pendekatan triple bottom line yang mencakup keselamatan pasien, ekonomi, dan lingkungan. Penelitian menggunakan desain evaluatif dengan pendekatan mixed-method sequential explanatory, melalui pengumpulan data kuantitatif berupa logbook penggunaan alat, data biaya, dan volume limbah tahun 2025, serta data kualitatif melalui wawancara mendalam, observasi, dan telaah dokumen. Hasil penelitian menunjukkan bahwa terdapat 96 penggunaan Harmonic Scalpel dengan proses ulang pada 18 unit alat hingga maksimal 5 siklus (72,2%), tanpa ditemukan kejadian infeksi daerah operasi terkait, serta tingkat kepatuhan audit CSSD sebesar 96,7%. Dari aspek ekonomi, proses ulang memberikan efisiensi biaya melalui pengurangan kebutuhan alat baru, sedangkan dari aspek lingkungan mampu menurunkan limbah alat sekali pakai dari 7,68 kg menjadi sekitar 1,44 kg per tahun (±81%). Namun demikian, masih ditemukan kendala pada sistem ketelusuran yang bersifat manual dan inkonsistensi pencatatan. Secara keseluruhan, proses ulang Harmonic Scalpel dinilai layak secara keberlanjutan karena tidak ditemukan bukti peningkatan risiko selama periode observasi, efisien secara ekonomi, dan ramah lingkungan, dengan catatan diperlukan penguatan pada sistem ketelusuran, validasi mutu, serta monitoring dan audit berkelanjutan untuk menjamin kualitas dan keamanan layanan.

The use of single-use medical devices such as the Harmonic Scalpel in laparoscopic procedures contributes to increased operational costs and significant medical waste generation, prompting the need for alternative strategies such as reprocessing that require comprehensive evaluation from a sustainability perspective. This study aimed to analyze the sustainability of Harmonic Scalpel reprocessing at Hospital X based on the triple bottom line approach, encompassing patient safety, economic efficiency, and environmental impact. An evaluative study design with a mixed-method sequential explanatory approach was employed, combining quantitative data from utilization logs, cost data, and waste volume in 2025 with qualitative data obtained through in-depth interviews, direct observations, and document reviews. The findings indicated a total of 96 Harmonic Scalpel uses, with 18 devices reprocessed up to a maximum of five cycles (72.2%), without any reported surgical site infections associated with reused devices, and a CSSD audit compliance rate of 96.7%. From an economic perspective, reprocessing significantly reduced the need for new devices, resulting in cost savings, while environmentally it reduced medical waste from 7.68 kg to approximately 1.44 kg per year (around 81% reduction). However, challenges were identified in the traceability system, which remains manual, and inconsistencies in documentation. Overall, the reprocessing of Harmonic Scalpel was found to be feasible from a sustainability standpoint, being safe for patients, cost-efficient, and environmentally beneficial, provided that improvements are made in traceability systems, quality validation, as well as continuous monitoring and auditing to ensure service quality and safety.