Tilting Exam Table

The primary reason for the design of these procto tables is to allow the abdominal contents to fall out of the pelvis, thereby straightening the sigmoid colon, which improves success with rigid sigmoidoscopy. When the table is tilted, the main section drops away from the patient's tummy allowing the back to arch naturally with no pressure being applied against the lower abdomen. The table is much more comfortable than the knee-chest position for the patient, and presents the anal canal at an adjustable working height for the examiner. When the patient is positioned properly with their arms above their head against the headrest, while they are inverted all of their weight is supported on the knees, thighs and elbows. Gravity makes the table essentially self-restraining as the foam rubber pads mold to the patient, and there is no way for the patient to move either forward or back while they are inverted.

SWEET! Thanks. I'd like to be on that table with a handsome doctor examining me.

Are these tables very common. Where in the world are you most likely to find them and in what kind of offices; would a family physician have one?

What do you consider to be a handsome doctor Ms. Fanny? 😉

Probably not in Canada Ricardo, a family physician would not have one in their office. Likely not a Gastroenterologist either, however in the USA I would expect that a GI Specialist would due to more favorable economics. Around here it would only be found in a hospital Outpatient Department or a GI Endoscopy Unit. This exact model has now been discontinued and replaced by a universal power chair, the Midmark Evolution 75.

The table has an extremely heavy base with a very low center of gravity which makes it perfectly rock solid and stable. The patient never feels like the table will tip over and is always very secure. It was built to last forever and due it's design probably will.

As far as specialist procto tables, this Ritter 75 was the apex since during it's production flexible sigmoidoscopy began to become routine and this style of table has become less common except for rectal procedures. Flexible sigmoidoscopy in the Left Lateral or Simm's position is now the usual because it is much less intimidating for the patient and can be performed on almost any gurney or exam table. However for rigid sigmoidoscopy and most proctological procedures, a Ritter table is still the ultimate. Since it converts to a full flat table with jack-knife capability, with the heel stirrups it may be used for virtually any other type of exam including other GI procedures such as colonoscopy.

Ooohhh ... how lovely is that!

I really really want to be examined on a procto table 😃 That really looks amazing.

I have been examined on one of those earlier power tables that were dedicated for proctoscopic exams. It raises you up so the part of your anatomy to be examined is about chest height on the doctor and it tilts your head down. That can be a little uncomfortable since it tends to jam your head into the head rest, or head stop in this case. Also, if you are sensitive to motion, it can leave you with a funny feeling in your head. The first time I had this exam done during a regular physical back in the 1970s, the doctor used a proctoscope, which is a rigid tube about 2 cm. in diameter and 25 cm. (10 inches) in length. It was an interesting feeling the way he had to basically straighten out the curves from the rectum to the lower part of the connecting colon. It was not painful in the least, for me anyway. Of course the first thing they did before this exam was done is give you a Fleet Enema and point you to the restroom to give it to yourself.

I have had the same exam on that table but with one of the newer instruments, the flexible sigmoidoscope. I know the flex-sig is the better of the two methods, but the rigid proctoscope exam was far more interesting to experience.

highndry

That can be a little uncomfortable since it tends to jam your head into the head rest.

This reinforces the importance of positioning the patient properly. If the headrest is adjusted correctly, the patient's elbows will rest against it when the arms are above their head. The patient's elbows and forearms should be placed together with the palms of the hands flat, the patient then rests their forehead in their hands. Their head should not touch the "headrest" at all and instead they are supported comfortably (and securely) by their elbows and forearms.

The patient may be a bit more comfortable if, after positioning their arms, a pillow is placed inside the forearms for them to rest their face in. Realistically a warning to patients however, this has another motivation other than your comfort. The pillow will keep the patient's arms fully extended above their head, and while inverted prevents the patient from moving their arms at all. It also serves to muffle any screams. 😉

When the patient is returned to the upright position at the conclusion of the exam or procedure, it is important for them to rest in that position for a few minutes. The patient will likely feel lightheaded, and may faint if they stood up immediately.

[quote author=DrJ58 link=topic=22795.msg220262#msg220262 date=1245248687]

The primary reason for the design of these procto tables is to allow the abdominal contents to fall out of the pelvis, thereby straightening the sigmoid colon, which improves success with rigid sigmoidoscopy. When the table is tilted, the main section drops away from the patient's tummy allowing the back to arch naturally with no pressure being applied against the lower abdomen. The table is much more comfortable than the knee-chest position for the patient, and presents the anal canal at an adjustable working height for the examiner. When the patient is positioned properly with their arms above their head against the headrest, while they are inverted all of their weight is supported on the knees, thighs and elbows. Gravity makes the table essentially self-restraining as the foam rubber pads mold to the patient, and there is no way for the patient to move either forward or back while they are inverted.

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Twice I have been on this exam table and inverted for an anal/rectal exam just as you described it. For me I loved it, very erotic, helpless and exposed to my doctor and nurse assisting him

Thanks Vicki. The Ritter is a 75 Evolution. I don't see any P after it. Google it. I see used Ritter 75 Evolution tables on ebay.

I can't believe these things actually exist. Somebody told me about some electric gyno chair the other day where it tilts the patient back in some strange angle and the seat actually drops away leaving her totally exposed. I can't understand the point of either of these things really. They both sound to me like very expensive ways to make the patient feel LESS comfortable and MORE embarassed....

I don't think that those procto tables exist much anymore now that flexible sigmoidoscopy and colonoscopy is so common.

However, I think that operating tables can still be configured in that way for performing certain anal / rectal surgical procedures.

I think maybe some Doctors have too much money and choose to indulge in some subconcious need to humiliate their patients!

We doctors need access to every area of the patient... even if that means strapping their thighs into leg cradles and tilting the table back : )

Ive been examined on one of those tilting tables. it was a dream come true to have an attractive female doctor and her assistant examining me.

I had the rigid proctoscope procedure done some years ago. I remember being tilted on the table but it wasn't really uncomfortable. But there were a number of pleasantries associated with this. First I had the fun of enemas until clear but actually they weren't as bad as the taste of the magnesium citrate (now that was really nasty). The modern clean out procedure is A LOT easier. Then the actual procedure made you feel like you were going to take a dump in the doctor's face (Of course I had a giant butt plug in place but it still felt like that.)

Medically necessary and absolutely kinky. I would love being on that table. ; )