Proctoscopy, or rectoscopy, 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 (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult ...
, 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 ''s ...
. A proctoscope is a short, straight, rigid, hollow metal tube, and usually has a small light bulb mounted at the end. It is approximately 15 cm (5 inches) long, while a rectoscope is approximately 25 cm (10 inches) long. During proctoscopy, the proctoscope is lubricated and inserted into the
rectum
The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult ...
, 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 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
Howard Atwood Kelly (February 20, 1858 – January 12, 1943) was an American gynecologist. He obtained his Bachelor of Arts, B.A. degree and Doctor of Medicine, M.D. degree from the University of Pennsylvania. He, William Osler, William Stewart ...
, 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 s ...
with the patient in
Sims' position. Fibre optic proctoscopes are now available which cause less discomfort to the patient.
The proctoscope is used in the diagnosis of
hemorrhoids, carcinoma of anal canal or rectum and
rectal polyp. 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, an interventional radiologist, or an interventional cardiology, interventional cardiologist. The process involves the extraction of sampling (medicine), sample ...
of a small amount of
tissue for examination under a
microscope
A microscope () is a laboratory equipment, 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 ...
. Also, air may be injected through the proctoscope to help make viewing easier. Similar instruments, the
sigmoidoscope and
colonoscope
Colonoscopy () or coloscopy () is a medical procedure involving the endoscopic examination of the large bowel (colon) and the distal portion of the small bowel. This examination is performed using either a CCD camera or a fiber optic camera, ...
may be used to visualize more proximal parts of the bowels.
See also
*
Anoscopy
*
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 insert ...
*
Hemorrhoids
*
Rectal dilator
*
Rubber band ligation
Notes
References
* Moore et al. (2010) ''Clinically Oriented Anatomy'' 6th edition
External links
{{Endoscopy
Colorectal surgery
Digestive system procedures