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

, 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 ''he ...

or rectal polyps and might be mildly uncomfortable as the proctoscope is inserted further into the rectum. Modern

fibre-optic An optical fiber, or optical fibre, is a flexible glass or plastic fiber that can transmit light from one end to the other. Such fibers find wide usage in fiber-optic communications, where they permit transmission over longer distances and at ...

proctoscopes allow more extensive observation with less discomfort.

Proctoscopes

A proctoscope is a hollow, tube-like

speculum The term speculum, Latin for "mirror", and its plural specula, may refer to: * ''Speculum'' (journal), a journal of medieval studies published by the Medieval Academy of America * Speculum (medical), a medical tool used for examining body cavities ...

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 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 patients for vaginal wall prolapse. The Sims Position is described as in ...

. Fibre optic proctoscopes are now available which cause less discomfort to the patient.
The proctoscope is used in the diagnosis of

, 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) ...

. It is used therapeutically for

polypectomy In medicine, a polypectomy is the surgical removal of an abnormal growth of tissue called a polyp. Polypectomy can be performed by excision if the polyp is external (on the skin). See also * Colonic polypectomy * Non-lifting sign Reference ...

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 Sigmoidoscopy ("sigma", 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 ...

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.

Notes

References

* Moore et al. (2010) ''Clinically Oriented Anatomy'' 6th edition

External links

{{Endoscopy Colorectal surgery Digestive system procedures