Increased throughput, improved patient comfort
Reasons for upgrading to transnasal
Many hospitals face a large backlog of endoscopic procedures due to the COVID-19 pandemic. Offering new techniques such as TNE (transnasal endoscopy) can improve the procedural and hospital efficiency, whilst enhancing the patient experience is, today, more vital than ever.
Transnasal endoscopy represents an effective alternative technique for diagnostic gastroscopy using ultrathin gastroscopes. It can be performed by trained nurses outside of the traditional endoscopy room – potentially freeing up space for complex therapeutic procedures. Additional major benefits for the patients are that they do not require sedation, minimising the overall risk of the procedure and recovery times.Discuss your options with us
*potential benefits realised from TNE
South Tees Hospital, NHS Foundation Trust, UKView case study
The advantages of transnasal endoscopy for your patients
"There is increasing evidence that TNE is better tolerated than standard endoscopy (…).
TNE is feasible and safe in a primary care population and is ideal for screening for upper gastrointestinal pathology. It has an advantage as a diagnostic tool in the elderly and those with multiple comorbidities due to fewer adverse effects on the cardiovascular system.”
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Maximizing patient comfort is one of the primary considerations of any medical procedure – and is especially important for techniques such as diagnostic gastroscopy, which some patients may find particularly daunting. In addition, healthcare services face one of their biggest challenges to date in overcoming the large backlogs of diagnostic tests and procedures caused by the COVID-19 pandemic. Finding new techniques that can improve hospital efficiency, whilst also enhancing the patient experience is therefore more vital than ever.
Data intelligence reports show that 100 million cancer screening tests were not performed in Europe as a result of the pandemic and one million cancer patients across Europe could be undiagnosed due to the backlog of screening tests, reduction and delays in referrals and restricted healthcare resources due to COVID-19 6 . This shows the significant effect that COVID-19 has had on patient backlogs and highlights the need to optimize diagnosis pathways such as endoscopy. Efficient alternatives, improvements and options are key.
With several key benefits for patients and endoscopists, transnasal endoscopy using advanced ultra-thin gastroscopes - such as those from Olympus - represents an effective alternative technique for diagnostic gastroscopy. As well as reducing patient discomfort, transnasal endoscopy procedures can be performed by trained nurses outside of the traditional endoscopic procedure room. This could potentially free up resources for further complex procedures, enabling staff to effectively work through backlogs and therefore diagnose and treat more patients.
While procedural efficiency has always been a priority for hospital organizations, the impact of the COVID-19 pandemic has left many facing a large backlog of endoscopic procedures, and generated a clear need for more efficient techniques.
By eliminating the need for sedation, transnasal endoscopy may remove the need for supporting nursing staff to monitor patient vitals, meaning that the procedure can be performed in smaller rooms that may be unsuitable for conventional oral gastroscopy. This not only increases the operational flexibility for hospitals, but may also free up resources for more complex therapeutic and diagnostic work – potentially increasing patient throughput and efficiency.
Patient preparation could be conducted outside of the procedure room prior to transnasal endoscopy allowing for more efficient use of the working space compared to traditional oral gastroscopy, which may increase the number of endoscopies performed per day.
As well as providing a more rapid procedure, progress in imaging technology means that the latest ultra-thin gastroscopes may also improve diagnostic capability. For example, the GIF-H190N and the GIF-XP290N advanced, ultra-thin gastroscopes from Olympus use the latest Narrow Band Imaging (NBI) technology. Gastroscopes with NBI technology in procedures such as Barret’s Surveillance may provide a higher diagnostic sensitivity and increased procedural efficiency 2 , 3 . Targeted biopsies may reduce the amount of tissue that needs to be taken by endoscopists, providing a safer option for patients as well as histology savings for hospital organizations.
Maintaining patient comfort during endoscopic procedures is a key consideration for hospitals. Medical device manufactures now offer advanced gastroscopes that combine ultra-slim design and advanced imaging capabilities such as high-definition imaging. These ultra-thin gastroscopes enable endoscopists to perform transnasal endoscopy, a technique with several key advantages over conventional oral gastroscopy, which may enhance patient experience 4 .
Physiological differences between the nasal and oral cavities mean that performing gastroscopy via the transnasal route may reduce gagging and retching, making the procedure far more tolerable for patients. Whilst a conventional oral gastroscopy may restrict tongue movement, intubating via the nasal cavity allows patients to talk to their endoscopist throughout their procedure – making the whole process potentially less stressful.
Another major benefit of transnasal endoscopy is that patients may not require sedation, meaning a safer endoscopic procedure. This is especially important for high-risk patients that may experience breathing difficulties during sedation, such as those with Motor Neurone Disease 4 . With no sedation, patients do not require an extended stay to recover, meaning they are free to carry on with their daily routine.
To ensure that patients continue to receive the highest quality of care in periods of high endoscopy demand, new technologies and techniques must increase procedural efficiency while ensuring that patient comfort is maximized.
By providing flexibility where procedures can be performed and decreasing the number of supporting staff required, transnasal endoscopy enables hospitals to redirect resources to other areas which may help endoscopists to reduce waiting time backlogs during periods of high patient numbers. For example, the introduction of a transnasal endoscopy service at the James Cook University Hospital in the UK, transformed a small and previously under-utilized room into a treatment room for performing this diagnostic procedure, helping to increase department efficiency 4 .
Transnasal gastroscopy with advanced gastroscopes from Olympus can provide a safer and more tolerable procedure that may be preferred by patients 4 . By providing flexibility in where procedures can be performed and increasing hospital efficiency, transnasal endoscopy offers an attractive alternative to support both endoscopists’ and patients’ needs.
Conventional Transoral Endoscopy (TOE) is often the standard diagnostic method used within the endoscopy unit to visualise the upper part of the gastrointestinal tract. Transnasal Endoscopy (TNE) is an upper endoscopy method which is performed by the nasal route using a thin endoscope less than 6 mm in diameter. The use of TNE can provide significant benefits in many areas, including patient safety, finance and strategic planning.