Techniques of Office-Based Endoscopy: Unsedated Transnasal Endoscopy

  • Toshitaka Hoppo
  • Blair A. JobeEmail author


Esophagogastroduodenoscopy (EGD) has been widely accepted as a diagnostic and therapeutic tool for the evaluation and management of foregut disease. Most of procedures are currently performed under conscious sedation in an outpatient setting to reduce patient discomfort. Conscious sedation, commonly achieved by moderate sedation with analgesia such as fentanyl and midazolam, is a depressed level of consciousness that allows patients to respond purposefully to verbal commands while continuously maintaining their own airway. However, most of the morbidity associated with EGD is related to sedation with narcotics and sedative agents (especially in older patients with cardiopulmonary disease), potentially leading to hypoxia, hypotension, cardiac arrhythmia, and respiratory failure. Sedation also requires the infrastructure and resources of specialized facilities and monitoring both during and after the procedure, which lead to significant associated cost and resource expenditure (direct costs).


Methylene Blue Early Gastric Cancer Percutaneous Endoscopic Gastrostomy Percutaneous Endoscopic Gastrostomy Tube Epiphrenic Diverticulum 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 18.1

Transanal endoscopy (TNE) Video. This video was created by Evan Dellon. Used with permission Perry AF, et al. Feasibility, Safety, Acceptability and Yield of Office-based, Screening Transnasal Esophagoscopy, Gastrointest Endoscopy 2012 Mar 15 [Epub ahead of print]. Copyright 2012 Elesevier [66] (MPG 64768 kb)


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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of SurgeryInstitute for the Treatment of Esohageal & Thoracic Disease, West Penn Allegheny Health SystemPittsbrughUSA

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