• Pradeep Bhandari, Sharmila Subramaniam, Michael J Bourke, Asma Alkandari, Chiu Philip Wai Yan PWY 0000-0001-9292-112X Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong., James F Brown, Rajesh N Keswani, Raf Bisschops, Cesare Hassan, Gottumukkala S Raju, V Raman Muthusamy, Amrita Sethi, Gary R May, Eduardo Albéniz, Marco Bruno, Michal Filip Kaminski, Maryam Alkhatry, Majid Almadi, Mostafa Ibrahim, Fabian Emura, Eduardo Moura, Claudio Navarrete, Adolfo Wulfson, Christopher Khor, Ryan Ponnudurai, Haruhiro Inoue, Yutaka Saito, Naohisa Yahagi, Sergey Kashin, Evgeniy Nikonov, Honggang Yu, Amit P Maydeo, D Nageshwar Reddy, Michael B Wallace, Mark Bennett Pochapin, Thomas Rösch, Prateek Sharma, and Alessandro Repici.
• Department of Gastroenterology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK pradeep.bhandari@porthosp.nhs.uk.
• Gut. 2020 Nov 1; 69 (11): 1915-1924.

AbstractThe COVID-19 pandemic has had a profound impact on provision of endoscopy services globally as staff and real estate were repurposed. As we begin to recover from the pandemic, a cohesive international approach is needed, and guidance on how to resume endoscopy services safely to avoid unintended harm from diagnostic delays. The aim of these guidelines is to provide consensus recommendations that clinicians can use to facilitate the swift and safe resumption of endoscopy services. An evidence-based literature review was carried out on the various strategies used globally to manage endoscopy during the COVID-19 pandemic and control infection. A modified Delphi process involving international endoscopy experts was used to agree on the consensus statements. A threshold of 80% agreement was used to establish consensus for each statement. 27 of 30 statements achieved consensus after two rounds of voting by 34 experts. The statements were categorised as pre-endoscopy, during endoscopy and postendoscopy addressing relevant areas of practice, such as screening, personal protective equipment, appropriate environments for endoscopy and infection control precautions, particularly in areas of high disease prevalence. Recommendations for testing of patients and for healthcare workers, appropriate locations of donning and doffing areas and social distancing measures before endoscopy are unique and not dealt with by any other guidelines. This international consensus using a modified Delphi method to produce a series of best practice recommendations to aid the safe resumption of endoscopy services globally in the era of COVID-19.© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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