Review: transanal endoscopic microsurgery (TEM)

Abstract

Transanal endoscopic microsurgery (TEM) is performed with the use of a complex operative system, which allows the application of all surgical techniques for dissection and suturing inside the rectal cavity up to a height of 20 cm from the dentate line. Gas dilation and stereoscopic vision give an optimal overview during the procedure. In sessile adenomas and carcinomas within the region of the extraperitoneal rectum, full thickness excision is the standard procedure. The postoperative course is completely painless in all excisions at some distance from the dentate line. The complication rate is low compared with other procedures and the recurrence rate in sessile adenomas (3.5%) lower than in conventional surgery as a result of the precise dissection which is possible under the magnified stereoscopic vision. In PT1 low risk cancer we found one recurrence in 29 patients.