Proctoscopy is a common medical procedure in which an instrument called a proctoscope (also known as a rectoscope, although the latter may be a bit longer) is used to examine the
anal cavity,
rectum
The rectum is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the sigmoid colon) at the l ...
, or
sigmoid colon
The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum and anus. It forms a loop that averages about in length. The loop is typically shaped like a Greek letter sigma (ς) or Latin letter S (thus ' ...
. A proctoscope is a short, straight, rigid, hollow metal tube, and usually has a small light bulb mounted at the end. It is approximately 5 inches or 15 cm long, while a rectoscope is approximately 10 inches or 25 cm long. During proctoscopy, the proctoscope is lubricated and inserted into the
rectum
The rectum is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the sigmoid colon) at the l ...
, and then the
obturator is removed, allowing an unobstructed view of the interior of the rectal cavity. This procedure is normally done to inspect for
hemorrhoids
Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term ''h ...
or rectal
polyps and might be mildly uncomfortable as the proctoscope is inserted further into the rectum. Modern
fibre-optic proctoscopes allow more extensive observation with less discomfort.
Proctoscopes
A proctoscope is a hollow, tube-like
speculum that is used for visual inspection of the rectum.
Both disposable and non-disposable proctoscopes are available for use. Out of these, the non-disposable Kelly's rectal speculum,
named after the American gynecologist
Howard Atwood Kelly, is the most commonly used speculum for proctoscopy. Some proctoscopes have a light source for better visibility. The proctoscope is inserted into the
anal canal
The anal canal is the part that connects the rectum to the anus, located below the level of the pelvic diaphragm. It is located within the anal triangle of the perineum, between the right and left ischioanal fossa. As the final functional segme ...
with the patient in
Sims' position
The Sims position, or left lateral Sims position, named after the gynaecologist J. Marion Sims, is usually used for rectal examination, treatments, enemas, and examining women for vaginal wall prolapse.
The Sims Position is described as in t ...
. Fibre optic proctoscopes are now available which cause less discomfort to the patient.
The proctoscope is used in the diagnosis of
hemorrhoids
Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term ''h ...
, carcinoma of anal canal or rectum and
rectal polyp
A colorectal polyp is a polyp (fleshy growth) occurring on the lining of the colon or rectum. Untreated colorectal polyps can develop into colorectal cancer.
Colorectal polyps are often classified by their behaviour (i.e. benign vs. malignant) o ...
. It is used therapeutically for
polypectomy and rectal biopsy.
Disposable proctoscopes without light are also available. The proctoscope also has a hollow channel through which other instruments may be inserted. For example, another instrument may be used to take a
biopsy
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a dise ...
of a small amount of
tissue for examination under a
microscope
A microscope () is a laboratory instrument used to examine objects that are too small to be seen by the naked eye. Microscopy is the science of investigating small objects and structures using a microscope. Microscopic means being invisi ...
. Also, air may be injected through the proctoscope to help make viewing easier. Similar instruments, the
sigmoidoscope
Sigmoidoscopy (from the Greek term for letter " s/ς" + "eidos" + "scopy": namely, to look inside an "s"/"ς"-like object) is the minimally invasive medical examination of the large intestine from the rectum through to the nearest part of the col ...
and
colonoscope may be used to visualize more proximal parts of the bowels.
See also
*
Endoscopy
An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inse ...
*
Anoscopy
*
Hemorrhoids
Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term ''h ...
*
Rubber band ligation
*
Rectal dilator
Notes
References
* Moore et al. (2010) ''Clinically Oriented Anatomy'' 6th edition
External links
{{Endoscopy
Colorectal surgery
Digestive system procedures