Kelly’s rectal speculum, commonly known as proctoscope has an outer sheath and a handle. The outer sheath is the speculun proctoscope and the inner rod is the obturator. The obturator is smooth and rounded. It fits exactly in the outer sheath.
Uses of Proctoscope:
The proctoscope is used in the diagnosis of haemorrhoids, carcinoma of anal canal or rectum, perianal fistula internal openng and rectal polyp.The proctoscope may also be used therapeutically for injectiion of haemorrhoids, polypectomy and rectal biopsy.
Proctoscopic examination procedure:
Positioning: The patient is placed in left lateral position with straight left leg at the
knee and right leg is drawn toward abdomen.
The patient is aked to take a deeep breath and a proctoscope lubricated with 2% lignocaine is introduced into anal canal.
The insertion of proctoscope into the anal canal must be carried out systematically.
The proctoscope is advancedforward and upward toward the umbilicus and then upward and backward towards the sacrum.
Obturator is then gradually withdrawn and light is thrown inside from a torch.
Interior of rectum is inspected while gradually withdrawing the sheath of proctoscope.
Hemorrhoidal plexus of veins can be seen bulging with a blue hue from the walls of the rectal canal.