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 in sertion was scored by the surgeon. Patients were blinded to which sigmoidos cope 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 videosiginoidoscope was 23 .2 (5.9) cm, which was significantly further than with the conventional sig moidosocpe 16.5 (3.8) cm (p < 0.01). The discomfort on a visual analogue sc ore 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 user s of the equipment (four surgeons and one colorectal nurse practitioner) pr eferred the videosigmoidoscope for image quality and ease of examination. Conclusions: A thinner, longer, rigid videosigmoidoscope is a more effectiv e means of looking at the proximal sigmoid colon. Despite being inserted fu rther, it caused less discomfort than the conventional sigmoidoscope. High- quality video images can be recorded or transmitted for real-time teleconsu ltation.