Rigid Sigmoidoscopy Periprocedural Care

Updated: Aug 15, 2016
  • Author: Iman Bayat, MBBS, MRCS, FRACS; Chief Editor: Vikram Kate, MBBS, MS, PhD, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS  more...
  • Print
Periprocedural Care

Equipment

The equipment required to perform rigid sigmoidoscopy includes the following items (see the image and video below):

  • Scope
  • Stylet (obturator)
  • Eyepiece
  • Bellows
  • Light source
  • Air filter
  • Water-based lubricant
  • Protective clothing as indicated (eg, gloves, apron, face mask, goggles)
Equipment needed for rigid sigmoidoscopy. Photo co Equipment needed for rigid sigmoidoscopy. Photo courtesy of Vicki Adams, Senior Medical Photographer, Mater Health Services Multimedia team.
Equipment for performing rigid sigmoidoscopy.

Sherwinter reports on a novel introducer constructed from available operating room supplies that converts a standard laparoscope into a high-definition rigid sigmoidoscope. [10]

If a light source fails—an event that is not uncommon—a temporary solution is to remove the bulb and mains supply unit from the light source and insert a disposable pen torch in its place. [11]

Next:

Patient Preparation

Anesthesia

Rigid sigmoidoscopy is most often performed without sedation.

Positioning

The left lateral (Sims) position, in which the patient lies on his or her left side with the hips and knees flexed and parallel (see the image below), is probably the position most commonly used for rigid sigmoidoscopy.

Rigid sigmoidoscopy. Sims position. Rigid sigmoidoscopy. Sims position.

In this position, the buttocks must overhang the edge of the bed, with the patient’s trunk angled obliquely across the bed, to permit the full maneuverability of the scope (see the video below); the more transverse across the bed, the easier the examination. A small sandbag may be placed under the left thigh or hip to provide elevation. This ensures that the head of the sigmoidoscope can be depressed below the level of the bed. [3, 4, 5, 12, 13]

Rigid sigmoidoscopy. Proper positioning and anatomy of patient.

An alternate position is the prone knee-elbow or jackknife position, in which the patient lays prone in an inverted position on a specialized table. These positions are particularly helpful for allowing the scope a considerable degree of maneuverability. When this position is desired but only a normal examination bed is available, a cooperative patient can still be placed in the knee-chest position. [3, 4, 5, 12, 13]

Previous