Transnasal OGD: Practice survey and impact of a live video retransmission

Background: Unsedated transnasal oesogastroduodenoscopy significantly improves patient tolerance compared to unsedated conventional peroral oesogastroduodenoscopy. Aims: To assess the adoption of transnasal oesogastroduodenoscopy among endoscopists from various European countries and its determinants. Methods: A survey was distributed to 624 endoscopists attending a live course on digestive endoscopy; a poll was also performed immediately before and after live video retransmission of a transnasal oesogastroduodenoscopy. Results: Answer rate was 48%; transnasal oesogastroduodenoscopy was practised by 31% of respondents. In multivariate analysis, practice of transnasal oesogastroduodenoscopy was associated with location in France and Netherlands (P < 0.0001), availability of many gastroscopes (P < 0.0001) and less frequent use of sedation (P = 0.006). Endoscopists who did not practise transnasal oesogastroduodenoscopy cited doubts about its advantages over conventional oesogastroduodenoscopy and lack of training (34% each) as barriers to adoption. Seventy-four percent of endoscopists practicing transnasal oesogastroduodenoscopy did actually use it in <20% of eligible cases. Live video retransmission of a transnasal oesogastroduodenoscopy increased the proportion of endoscopists interested in this technique (P = 0.006). Conclusions: Adoption of transnasal oesogastroduodenoscopy largely varies between European countries; endoscopists practicing this technique use it in a minority of eligible cases. Live case demonstration may decrease barriers to the adoption of this technique.