Peroperative coloscopy

Abstract

Peroperative coloscopy is coloscopy done in conjunction with laparotomy. Progression of the coloscope is aided by manipulation of the bowel by the surgeon who can thus steer its tip to a doubtful area under simultaneous visual control by the endoscopist. Important diagnostic problems can easily be solved with this technique which now represents a further application of gastrointestinal endoscopy. Although present flexible fibreoptic endoscopes will usually easily negotiate the various obstacles and bends strewn along the gastrointestinal tract, some parts of the large bowel can sometimes only be reached with great difficulty and lesions in these areas are not easily detected. There may be difficulty in passing the flexures and other parts of the large bowel to reach the terminal ileum. The two main advantages of peroperative coloscopy are:

• the surgeon can examine the bowel with transillumination which shows up the fine vascular networks and possible shadows due to endoluminal or intramural lesions;

• the endoscopist can easily reach any part of the large bowel and thus supply the surgeon with exact information on the pathological anatomical conditions there.