Potential methods in which a transnasal endoscopy service can be expanded beyond standard diagnostic procedures within an endoscopy department
| Category | Scenario | Example |
| Diagnostic | GI bleed | Assessment of lower risk bleeds (eg, Glasgow Blatchford score 0 or 1) in the emergency department to triage towards therapeutic endoscopy or facilitate early discharge |
| Portal hypertension | Hepatology/portal hypertension outpatient clinic to diagnose/grade varices | |
| Dysphagia | Dysphagia outpatient clinic encompassing focused history, and if appropriate direct endoscopic examination | |
| Community screening | Procedures performed in community diagnostic hubs or mobile vehicle | |
| Therapeutic | NJ tube | Placement of guidewire and NJ tube to overcome difficult oronasal transfer step |
| PEG placement | Nasal unsedated seated PEG placement | |
| Stricture management | Able to more easily traverse difficult strictures to characterise them and assist with guidewire passage and dilatation Direct visualisation of dilatation of upper oesophageal strictures Can be passed through gastrostomy to assist with combined antegrade–retrograde dilatation procedure | |
| Dual endoscopy | Scope passed alongside a gastroscope to assist in retraction of lesions and facilitate endoscopic dissection |
GI, gastrointestinal; NJ, naso-jejunal tube; PEG, per oral endoscopic gastrosotomy.