Definition

Rigid sigmoidoscopy is a visual examination of the distal sigmoid colon and rectum using a rigid tube with a light source, called a sigmoido-scope. It consists of an outer hollow plastic or metal tube, an introducer which is withdrawn after the instrument has been inserted, and a light source. There is a hand pump connected by tubing so air can be insufflated to open up the bowel lumen ahead of the instrument.

Indications

Rigid sigmoidoscopy is indicated in the investigation of rectal bleeding. It can be used as a vehicle for biopsy of the rectum, for example in suspected inflammatory bowel disease or colorectal cancer. It can also facilitate decompression and reduction of sigmoid volvulus.

Procedure

PRE-PROCEDURE CONSIDERATIONS

1. ▪ Ask the patient to evacuate the rectum, or clear it by administering glycerine suppositories or an enema prior to the procedure.

2. ▪ Explain the procedure, including the reasons why you are doing it and the fact that it should cause only minor discomfort. Warn the patient they may experience the urge to defaecate or pass flatus during the procedure. Verbal consent is sufficient.

3. ▪ Check your equipment, including light source.

4. ▪ Position the patient correctly in the left lateral position, hips flexed and buttocks extending over the edge of the examination couch.

5. ▪ Ensure adequate lighting.

6. ▪ Inspect the perianal skin then perform a preliminary digital rectal examination to ensure nothing is blocking the rectum, followed by proctoscopy.