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The distal alimentary canal consists of the sigmoid colon and rectum which terminates at the anus.  These are the areas that are examined with a sigmoidoscope.

For performing the examination with the rigid sigmoidoscope, the patient must lie on the left side, in the so called sims position or the knee chest position. The bowels are previously emptied with a suppository and a digital rectal examination is first performed. The sigmoidoscope is lubricated and inserted with obturator in general direction of the umbilicus. The direction is then changed and the obturator is removed so that the physician may penetrate further with direct vision. A bellows is used to insufflate air to distend the rectum. Lateral movements of the sigmoidoscope's tip negotiate the houston valve and the S curved recto-sigmoid junction.

A visual description of the rigid sigmoidoscope or proctoscope being inserted.

For a flexible sigmoidoscopy, the patient must lie on his or her left side on the examining table. The physician inserts a short, flexible, lit tube into the rectum and slowly guides it into the colon. The tube is called a sigmoidoscope. The scope transmits an image of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. The scope also blows air into these organs, which inflates them and helps the physician see better.

Patient in the sims position for a flexible sigmoidoscopy exam and the knee chest position for a rigid sigmoidoscope exam.

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Video demonstration of a flex sig or colonoscopy.

Video demonstration of a patient having a rigid sigmoidoscope explained.  The exam may be viewed at proctoscopeexam.com