Speculum (medical)

A speculum (Latin for "mirror"; plural specula or speculums) is a medical tool for investigating body orifices, with a form dependent on the orifice for which it is designed. In old texts, the speculum may also be referred to as a diopter or dioptra. Like an endoscope, a speculum allows entry into a body cavity; endoscopes, however, tend to have optics while a speculum is intended for direct vision.

Vaginal and anal specula were used by the ancient Greeks and Romans, and speculum artifacts have been found in Pompeii. A vaginal speculum, developed by J. Marion Sims, consists of a hollow cylinder with a rounded end that is divided into two hinged parts, somewhat like the beak of a duck. The speculum is inserted into the vagina to dilate it for examination of the vagina and cervix.

Specula were formerly made of stainless steel, and sterilized after use. However, many, especially those used in emergency departments and doctor's offices, are now made of plastic, and are disposable, single-use items. Those used in surgical suites are still commonly made of metal.

Specula come in a variety of shapes based on their purpose, and a variety of sizes; in any case the cylinder or blade(s) of the instrument allow the operator a direct vision of the area of interest and the possibility to introduce instruments for further interventions such as a biopsy.

The best-known speculum is the bivalved vaginal speculum; the two blades are hinged and are "closed" when the speculum is inserted to facilitate its entry and "opened" in its final position where they can be arrested by a screw mechanism, so that the operator is freed from keeping the blades apart.

A cylindrical-shaped speculum, introduced in 2001, the dilating vaginal speculum (also known as the Veda-scope) invented by Clemens van der Weegen, inflates the vagina with filtered air. (see diagram) The device has two main functions: a) to take a normal Pap smear with a cervical brush or a cytology brush; and b) as an internal colposcope so that the operator can pivot the Veda-scope to view any part of the vagina barrel and cervix facilitated by an internal light source that can illuminate the vaginal wall and cervix with multi-coloured light filters, which can detect pre-cancerous cells with the aid of acetic acid solution and iodine solution. It also has a facility to attach a digital camera for viewing and recording.

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