ABSTRACT
Instrumentation Proctoscopy The proctoscope ( Fig. 1 ) has an internal obturator aiding insertion with an adjacent light source. There is no requirement to insufflate the rectum with air. After adequate lubrication, it is inserted into the rectum with the obturator in place, until the sphincter resistance is overcome, after which the obturator is removed. The lower rectal mucosa is visualized on slowly withdrawing the proctoscope with attention to the hemorrhoidal cushions, dentate line, and anal epithelium. It is helpful to the physician if the patient is asked to “bear down” as this may help demonstrate prolapsing mucosa and hemorrhoids, the latter can be banded or injected with a sclerosant.
