The flexible sigmoidoscope is a flexible fiberoptic or video endoscope designed to examine the mucosal surface of the sigmoid colon and rectum. The flexible sigmoidoscope represents a technologic advancement over the earlier rigid sigmoidoscopes that were hindered by the relatively short length of bowel they could visualize and the rather uncomfortable examination the patient was required to endure in its use. The technical design of the flexible sigmoidoscope provides a more comfortable examination for the patient, and the longer length of the scope allows for the evaluation of more of the colon with the potential for the detection of a greater number of lesions. Studies have shown its superiority over the rigid sigmoidoscope in terms of patient discomfort, anxiety, and compliance.<sup>24 Winawer S.J., Miller C., Lightdale C. , e al. Patient response to sigmoidoscopy: A randomized, controlled trial of rigid and flexible sigmoidoscopy Cancer 1987 ;  60 : 1905-1908  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Also, studies have shown the ability of the flexible scope to detect a significantly greater number of malignant and premalignant lesions compared with the rigid instrument.<sup>23 Wilking N., Petrelli N.J., Herrera–Ornelas L. , e al. A comparison of the 25–cm rigid proctosigmoidoscope with the 65–cm flexible endoscope in the screening of patients for colorectal carcinoma Cancer 1986 ;  57 : 669-671  [cross-ref]

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The flexible sigmoidoscope has clinical usefulness in the evaluation of many disease processes that involve the rectum and sigmoid colon. Many consider it the primary diagnostic modality for examination of the rectosigmoid. In addition, the role of flexible sigmoidoscopy in screening asymptomatic individuals for neoplastic lesions of the colon and rectum, although not completely defined at this time, appears to be expanding. The proximal migration of colorectal neoplastic lesions has created a need to rely on detection methods that examine greater lengths of colon. As this need grows and as technical improvements in sigmoidoscope design and imaging capabilities continue, the utilization of the flexible sigmoidoscope should expand.