The Green Surgery Challenge team at Wrexham Maelor and Ysbyty Gwynedd Hospitals, Betsi Cadwaladr University Health Board in North Wales, focused on the carpal tunnel release pathway as this is the most commonly performed procedure in the field of hand surgery. They considered the whole pathway and chose interventions that would reduce the consumption of single-use surgical equipment and reduce energy use by moving out of the operating theatre, reducing size of autoclave trays by streamlining the reusable surgical sets and eliminating the need for ward admission.