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Transnasal Gastroscopy: everything you need to know

What is and when to do it

La Gastroscopia Transnasale (GTN) is a painless and completely tolerable diagnostic examination for evaluating upper digestive tract pathologies. Talking about this technique means delving into a minimally invasive method that has proven efficacy. Although officially introduced in 1994 by the gastroenterologist Shaker R., this investigation is not yet widely used; indeed, it is only employed in the best-equipped specialized centers in Italy and around the world.

Gastroscopy Transnasal is necessary when there are pathologies affecting the esophagus, stomach, and duodenum, defined as “diseases of well-being” due to their prevalence, especially among Western populations, whose diet is often rich but poorly balanced.

Being one of the latest innovations in the field of digestive endoscopy, transnasal gastroscopy aims to overcome the discomfort and side effects of traditional gastroscopy. Individuals with coagulation issues or nasal cavity alterations cannot undergo this type of test.

What is and how it lasts

The phases preceding transnasal gastroscopy, as well as its preparation, consist of a few simple steps:

  1. Fasting for at least 6 hours before the procedure.
  2. Continuing to take any medications (except antacids and anticoagulants).
  3. Avoiding solid foods from the previous evening.
  4. Refraining from smoking.
  5. Ingesting only small amounts of water, preferably not immediately before the procedure.
  6. Informing the doctor about any therapies followed and any allergies.

Equally clear and simple are the procedural steps that characterize this diagnostic examination, during which the patient can be positioned either on their left side or seated, depending on their needs.

After positioning the patient, the specialist applies a topical anesthetic spray, also known as contact anesthetic, in the nasal cavity before introducing the transnasal gastroscope, whose dimensions can range from 4.9mm to 6mm. The probe begins its examination in the esophagus and continues to the duodenum. This phase of the examination may involve, if necessary, the collection of material from the organ walls for biopsies or other tests.

Generally, unless operations or biopsies are performed, the examination lasts from 5 to 10 minutes and concludes with the removal of the endoscope through the patient’s nasal cavity.

Which are the advantages

The differences between the two techniques are significant: transnasal gastroscopy is also comparable to transoral gastroscopy. The initial skepticism due to the limited diffusion of the transnasal technique, perhaps because of the significantly smaller size of the instrument used (over 3mm less), has over time given way to a proven diagnostic and operative reliability.

In summary, here are the advantages for patients:

  1. No need for anesthesia and sedation: fewer risks of complications.
  2. Insertion of probes through the nose: less discomfort compared to traditional gastroscopy, which involves access through the throat.
  3. Better patient experience: ability to swallow and communicate with the doctor, absence of sensations of choking, vomiting, constriction, less stress, and emotional tension.
  4. Fewer hospital resources used and intelligent use of hospital spaces: the absence of anesthesiologists reduces the number of medical resources required for the examination.
  5. Immediate resumption of the patient’s daily activities.

Is it possible to have  Transnasal Gastroscopy at Minihospital “Sandro Pertini”?

In the limited list of Italian centers capable of performing a transanal gastroscopy examination, MiniHospital “Sandro Pertini” stands out, where the procedure is carried out by Dr. D’Imporzano. The technological equipment available at this Pisan excellence, combined with the presence of a team of professionals with proven experience and quality, make MiniHospital a center of excellence in this field as well, adding to its renowned areas of intervention: specialized outpatient medicine, surgery, diagnostic imaging, and rehabilitation medicine.

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