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TransNasal Esophagoscopy (TNE)

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TNE stands for TransNasal Esophagoscopy. It is a method of examining the esophagus, the structure that connects the throat to the stomach, without putting someone to sleep or giving any sedation. The traditional method of examining the esophagus was to  place a large round camera, think of a garden hose, through the mouth then into the esophagus and stomach. One has to be sedated with intravenous medication or medication in the vein, so that one doesn’t gag during the procedure. The gag reflex is actually located in the mouth. However, by going through the nose one bypasses the gag reflex. So by using an ultrathin camera, the size and texture of a cooked piece of spaghetti, the gag reflex can be bypassed, and the esophagus can then be examined without having to sedate or knock out the patient. It’s much safer for the patient as almost all the risks of upper endoscopy are not related to the procedure itself, but to the sedation administered during the procedure. So people should be aware that there are alternatives to traditional sedated endoscopy.

TNE is one-fifth the cost of traditional sedated endoscopy. TNE is performed not only by ENT doctors but by gastrointestinal doctors as well. To understand the potential positive impact of awake upper endoscopy or an unsedated exam of the food pipe, there are approximately 10 million upper endoscopies performed each year in the United States. The facility fee, that which the insurance companies, including medicare and medicaid, pay when the procedure is done under sedation, averages an extra $1000/ procedure. Or 10 Billion dollars a year. Conservatively, half of these procedure could be done with the patient awake, therefore saving us taxpayers 5 billion a year. Even more important is the greater patient safety when people don't need to undergo sedation. TNE is a medical advance exemplifying one of those rare situations where not only can the entire healthcare industry save money, but it is much safer for patients.



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