Evolution in Endoscopy Center Design

Endoscopy centers have long served as critical sites for diagnosing gastrointestinal conditions through minimally invasive procedures. Historically, these facilities were optimized for diagnostics with procedures like colonoscopies, upper endoscopies, or sigmoidoscopy that required relatively simple infrastructure and modest recovery spaces.

But today, the capabilities of endoscopy centers are rapidly expanding. What was once a setting for routine exams and minor interventions is now evolving into a hub for increasingly complex therapeutic procedures. This clinical shift is driving a corresponding evolution in facility design, one that balances safety, flexibility, and technology integration.

Diagnostic Roots: Simplicity and Efficiency

Traditional endoscopy centers focused primarily on identifying abnormalities. The infrastructure requirements were minimal: small procedure rooms, basic scope reprocessing areas, moderate sedation capabilities, and limited recovery bays were common. Patient turnover was quick, and equipment needs were relatively modest.

These facilities were built for efficiency, with a strong emphasis on throughput and infection control, but with fewer demands related to surgical infrastructure or advanced monitoring.

Therapeutic Expansion: A New Era of Complexity

Today, the line between diagnostic and therapeutic endoscopy is blurring. More centers are now performing advanced interventions such as endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, stent placements, sphincterotomy, photodynamic therapy, and endoscopic weight-loss procedures.

These therapies often require deep sedation, and sometimes general anesthesia, mandating enhanced monitoring systems, emergency preparedness, and robust recovery spaces. This may impact the risk category of the spaces and add new design imperatives, from increased procedure room sizes to enhanced electrical, HVAC, and medical gas systems.

Key Design Shifts in Today’s Endoscopy Facilities

As procedures expand, so too must the facility’s architecture and systems. Some of the key shifts include:

• Procedure Room Design: Rooms must accommodate more equipment and personnel for complex interventions. Some now include lead shielding to support mobile C-arm use, and modular booms or ceiling mounts to enhance workflow flexibility.

• Recovery and Monitoring: Some facilities now require dedicated Phase I recovery areas with staff stations for continuously monitoring patients, especially when deeper sedation is used. Emergency response systems, including crash carts and advanced airway management tools are necessary components.

• Scope Reprocessing: With increased procedural volume and infection prevention standards, reprocessing spaces are becoming more sophisticated, incorporating specialized and adjustable-height sinks, through-wall scope cleaners, and smart drying cabinets with HEPA filtered drying and digital tracking systems.

• Sedation & Facility Classification: The type and depth of sedation used can trigger different regulatory classifications, especially when deep sedation or general anesthesia are introduced. This may affect HVAC design, room size, medical gas supply, emergency electrical provisions, and fire protection systems.

• Flexibility for Growth and Innovation: Given the speed of technological and clinical change, today’s centers are being designed with adaptability in mind. Features like movable equipment carts, modular storage, and scalable infrastructure allow the space to evolve with emerging therapies and technologies.

Balancing Standards, Compliance, and Practicality

Many endoscopy centers, especially in CON states, operate as office-based centers. These centers usually have to be accredited by one of the accrediting bodies to satisfy state requirements. As the complexity of procedures increases, it will become more common for endoscopy centers to seek licensure and Medicare certification to garner the higher reimbursements of an ASC. When meeting ASC standards, designers must be careful to follow state regulations and Medicare Conditions for Coverage to assure compliance. This typically imposes more stringent design criteria on the facility, and while this enhances the safety and functionality, it can add significant cost to construction.  Consequently designers and operators need to think critically about how to balance regulatory expectations while preserving efficiency and affordability.

The Road Ahead: Integration with Ambulatory Surgery Models

As the boundary between office-based procedures and ambulatory surgery centers continues to fade, endoscopy centers may increasingly resemble full-fledged ASCs. The incorporation of robotic technologies, AI-enhanced imaging, and hybrid operating rooms may soon become the norm, further redefining what these facilities can achieve.

This evolution calls for a design philosophy that aligns with where care is going, not just where it’s been. For architects, clinicians, and developers alike, that means planning for complexity, enabling flexibility, and building with the future of minimally invasive care in mind.