Technique and results using the glass-rectoscope for tumour resection

The glass-rectoscope, developed by P. Dewey is a cylinder speculum with a closed end and a working window at the side. This is a cheap instrument and method for transanal approach to the lower rectum. After preparation of the patient by saline lavage the day before operation and one dose antibiotic preoperatively, the operation is performed under general or epidural anesthesia. The digital slow dilatation of the anal sphincter is followed by introduction of the instrument, of which several versions are available. After focusing the lesion in the working window, diathermy-excision of the mucosa or of the total rectal wall is performed. Bleeding is controlled by electrocoagulation or by continuous suture of the resulting defect in the rectal wall. In 34 patients treated by transanal tumour resection, there was one local infection and four postoperative haemorrhages required operative revision by resuture. The method is suitable for removing lesions of the lower rectum up to the diameter of 2 cm and for stage T1N0 malignant lesions.