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Transanal endoscopic microsurgery

Transanal endoscopic microsurgery (TEM) is a minimally invasive surgical technique that allows the removal of polyps and small cancers from the rectum that are too large to be removed by traditional colonoscopy.

The TEM instrument is introduced through the anus under general anaesthesia. The surgeon�s view is optimised by distending the rectum with low pressure gas (CO2) and the use of magnifying binocular operating scope to give a 3-dimensional operating field. The surgeon uses precision instruments to carefully remove the tumour with a disk of surrounding rectal wall. The surgical defect can then be stitched closed.

Most patients are only in hospital for one or two nights and generally cope well with the surgery, quickly returning to normal health. The piece of bowel that is removed is sent for analysis. The results of this are very important in determining if further treatment is required.

Originally, TEM was used for benign polyps or growths in the rectum. However, it is possible to successfully treat small, early stage cancers of the rectum that would otherwise require major abdominal surgery. There is also some evidence that TEM surgery can be used to remove cancers of the rectum that have responded well to traditional treatment such as radiotherapy. However, this is not routine and is still the subject of research trials.

The technique of TEM was first developed by Professor Buess in the 1980�s. The operation has been adopted by many centres throughout the World and within the UK interested centres contribute information regarding patient treatment and outcomes to the UK TEM database. This database has been very important in guiding further development of TEM surgery.

Several hospitals in the U.K. offer specialist TEM surgery. Click a link on the right to display further information on any of these specialist hospitals