Comfort-First Endoscopy: Sedation, TNE & Economics of Patient Experience
Comfort is both a patient outcome and an economic one: sedation choice drives staffing, recovery and throughput. This session makes the argument, then proves it on the meeting's own director of quality.
Running order (indicative)
- Head
- Prof David Tateanchors the studio throughout
- Talk 1
- Dr Ben ColleypriestTransnasal Endoscopy Done Properly: Technique, Comfort and the Access Dividend
- Talk 2
- Dr Manmeet MatharooHave We Swung Too Far? Sedation Models by Procedure and Jurisdiction
- Live case
- Dr Ben ColleypriestProf Raf BisschopsUnsedated transnasal endoscopy (TNE) — comfort-first stomach assessment
- Discussion
- Allremaining session time
The session, as written
Lecture 1 — Transnasal endoscopy done properly. (Colleypriest). The technique, step by step, diagrams first — what TNE offers and where its honest limits are (nasal anatomy, epistaxis, therapeutic reach, biopsy) — and the access dividend: Scotland runs TNE from outreach units that patients visit on the way to work. An endoscopy service in a supermarket car park is a serious value question, not a joke — value from the punter's side of the couch: no sedation, no recovery bay, no escort, no day off work. Then he heads for the procedure room.
Lecture 2 — Have we swung too far? Sedation models by procedure and jurisdiction. (Matharoo). Delivered while the room next door is prepared. The honest matrix: ERCP is not OGD is not colonoscopy, and propofol lists against conscious sedation against nothing at all — with two truths said out loud. Propofol is a one-way door: almost no unit that adopts it ever goes back. And the UK may have swung too far the other way — if you're going to sedate, sedate properly, or the "cheap" procedure quietly becomes a low-quality one.
The set-piece — live unsedated TNE, on the faculty. Ben Colleypriest scopes Roland Valori — live, unsedated, distal cap. And while the scope is in his nose, the two of them discuss what they're seeing: image quality, what the examination can honestly deliver, what it can't. The meeting's most senior advocate for quality, demonstrating with his own comfort what the economics of patient experience actually mean. A recorded case stands by as backup; the studio carries the commentary.
Discussion — what would it take in your unit? Patient selection, list design, and why "unsedated" is a pathway decision, not an act of bravado.
