Rigid videosigmoidoscopy vs conventional sigmoidoscopy. A randomized controlled study.

BACKGROUND

Not only is rigid sigmoidoscopy uncomfortable for patients, but visualisation of the rectosigmoid junction and sigmoid colon is successful in only 40-70% of examinations. A novel fine-bore rigid videosigmoidoscope is described and then compared with a rigid conventional sigmoidoscope for patient discomfort and length of insertion.

METHOD

A total of 58 patients were examined with both sigmoidoscopes in a random order. Discomfort was scored on a visual analogue scale; length of insertion was scored by the surgeon. Patients were blinded to which sigmoidoscope was being used. The images from the video examination were transmitted in real time for a second opinion in a different hospital.

RESULTS

The mean (SD) insertion distance of the videosigmoidoscope was 23.2 (5.9) cm, which was significantly further than with the conventional sigmoidosocpe 16.5 (3.8) cm (p < 0.01). The discomfort on a visual analogue score for the videosigmoidoscope was 3.0 (1.8), which was significantly less than for the conventional sigmoidoscope 5.5 (2.7) (p < 0.01). The five users of the equipment (four surgeons and one colorectal nurse practitioner) preferred the videosigmoidoscope for image quality and ease of examination.

CONCLUSIONS

A thinner, longer, rigid videosigmoidoscope is a more effective means of looking at the proximal sigmoid colon. Despite being inserted further, it caused less discomfort than the conventional sigmoidoscope. High-quality video images can be recorded or transmitted for real-time teleconsultation.