By Dr. med. Ernst Stein (auth.)
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Additional resources for Anorectal and Colon Diseases: Textbook and Color Atlas of Proctology
Older, less mobile patients tolerate this position better than the prone jackknife position. Reference 1. Bond JH, Levy M, Levitt MD (1976 ) Explosion of hydrogen gas in the colon during proctosigmoidoscopy. Gastrointest Endosc 23: 41-42 Disinfection and Sterilization A number of factors combine to increase the risk of nosocomial infections in clinic and hospital proctologic procedures. Both the diagnostic and therapeutic procedures have become quite complex. In addition, increasing demand and financial pressures have lead to a much higher turnover of patients in the specialized examination areas.
The ionizing irradiation only slightly warms the material to be sterilized, and also penetrates easily through packaging material. Thus it is suitable for sterilizing sensitive medical instruments and is used in the pharmaceutical industry to sterilize packaged products. Disinfection and Sterilization of Instruments When endoscopic procedures involve non-sterile body areas such as the rectum, thorough cleaning of the instruments followed by disinfection is sufficient. On the other hand, when endoscopic procedures require passing the instrument through the skin and subcutaneous tissue or into normally sterile body cavities, it is standard practice to use sterilized instruments and accessories, although in many instances this strategy appears to be overly cautious.
Examination positions. Top, Sims (modified left lateral decubitus); middle, prone jackknife; bottom, dorsal lithotomy This position is uncomfortable when employed on a nonadjustable table. For this reason, special proctologic tables are usually employed on which the patient kneels on a ledge and the body is tilted forward. Such tables can also be employed for the dorsal lithotomy position by adding leg rests. When the head is lowered, the gastrointestinal contents are also shifted by simple gravity.