Before a sigmoidoscopy, the patient should give informed consent and be sited in the left lateral position with the hips flexed and the buttocks raised.
A digital examination is carried out on the rectum. If loaded, sigmoidoscopy is deferred until the bowel has been prepared with a disposable enema.
The sigmoidoscope is lubricated with K-Y jelly. The obturator is placed gently into the rectum and advanced towards the umbilicus about 5 cm. The obturator is then removed and advance of the tube is carried out under direct vision with the use of eye piece, light source and insufflator. Negotiation of the rectosigmoid junction requires considerable skill; patient discomfort should contraindicate further advancement.
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