Breaking new ground when in pediatric medicine is something Children’s Hospital Los Angeles (CHLA) is esteemed for, as is the case with its Transnasal Endoscopy Program (TNE). The first of its kind in Southern California, CHLA’s TNE program is used with children undergoing upper endoscopies for gastrointestinal (GI) tract issues. And now they’re offering transnasal endoscopy without sedation through the use of Virtual Reality.
“During the TNE, a tube is inserted up the child’s nose so a camera can examine their throat, upper and lower GI tracts,” Jeffrey I. Gold, PhD, CHLA’s director of Children’s Outcomes, Research, and Evaluation (C.O.R.E.) Program and Pediatric Pain Management Clinic tells Parentology. “Because of CHLA’s work with virtual reality (VR), we’re able to perform TNE’s without sedation.”
The lead-up to the procedure is much simpler as a result, too. “With a regular endoscopy scheduled on a Monday, a child would need to stop eating on a Sunday night,” Gold says. Not so with TNE, which cuts down on nothing by mouth (NPO) time. And, in most cases, an upper GI endoscopy with biopsies requires deep sedation or general anesthesia. Gold says, “It can take two hours for a child to wake up from this anesthesia, leaving them woozy, nauseous and unable to attend school that day.”
TNE paired with VR allows for the technique to take place in an outpatient setting with the child remaining non-sedated and awake. A numbing agent is used in the nose and throat when a small endoscope is passed through the nose to the esophagus and stomach, where biopsies are taken. When the procedure is complete – Gold calculates it lasts less than an hour — there’s no recovery time or side effects, with kids able to immediately return to school or other activities.
CHLA also uses VR with pediatric procedures that can cause pain and anxiety such as blood draws, dialysis and chemotherapy. What Gold foresees for VR’s growing use at CHLA, “Our goal is to continue using VR in various hospital environments where we think it could have an impact towards reducing or eliminating the need for medication.”