[Digital videoproctoscopy: a new diagnostic test in proctology]

The proctological examination is usually simple, it can be done even without specific preparation. It is completed by proctoscopy, enabling the surgeon to confirm a clinical suspicion and make a differential diagnosis. Proctoscopy, however, may present a number of difficulties: the embarrassing position (both in the Sims and in the genupectural position; the operator is very close to the perineum of the patient); it is not possible to provide visual evidence of the pathology; there are no data archives; no comparison of two examinations can be made after a certain period of time (e.g. to test the validity of the therapy adopted). For these reasons patients are often invited to undergo a video-colonoscopy, which also presents limitations such as low patient compliance, difficult medium- and short-term repetition; ineffective discrimination of anal canal diseases, and, last but not least, the cost, which is substantially higher than that of anoscopy. The Author presents the results of experimentation with digital Videoproctoscopye (Proctomedia s.r.l., Rome, Italy), performed with the aid of a bar on which is situated a separate-head digital camera, a solid light source with an optical fibre guide, and an insufflation channel. The top of the bar can be attached with a bayonet coupling to a disposable rigid proctoscope. The tool is connected to a high-resolution LCD monitor and to a high-definition digital tape with an ethernet card, allowing the surgeon to record images on an SD card. Three hundred and seventy-six digital videoproctoscopies were carried out, enabling the author to make a correct diagnosis of the anal, perianal and rectal pathologies.