Surgical Endoscopy

, Volume 2, Issue 2, pp 71–75

Technique of transanal endoscopic microsurgery

  • G. Buess
  • K. Kipfmüller
  • D. Hack
  • R. Grüßner
  • A. Heintz
  • T. Junginger
Original Articles

DOI: 10.1007/BF00704356

Cite this article as:
Buess, G., Kipfmüller, K., Hack, D. et al. Surg Endosc (1988) 2: 71. doi:10.1007/BF00704356

Summary

Sessile adenomas are predominantly localized in the rectum and lower sigma. Surgical removal is indicated but often implies an invasive surgical procedure. Using conventional transanal surgical techniques, only the lower rectum can be reached and there are high rates of recurrence. The new technique combines an endoscopic view of the rectum under gas insufflation via a stereoscopic telescope with conventional surgical preparation and suturing. Adenomas can be excised using the mucosectomy technique or full-thickness-excision, whereas carcinomas should be excised using full-thickness excision with a sufficient border of healthy mucosa. In carcinomas of the sacral cavity, we remove the retrorectal fat up to the fascia of Waldeyer, including the regional lymph nodes. Transanal endoscopic microsurgery is the most economical and tissue-saving surgical technique for the removal of rectal adenomas and early rectal carcinomas.

Key words

Rectal adenomaEarly rectal carcinomaRectal surgeryEndoscopic microsurgeryTransanal surgeryPolyp surgery

Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • G. Buess
    • 1
  • K. Kipfmüller
    • 1
  • D. Hack
    • 1
  • R. Grüßner
    • 1
  • A. Heintz
    • 1
  • T. Junginger
    • 1
  1. 1.Klinik und Poliklinik für Allgemein- und Abdominalchirurgie der Johannes-Gutenberg-UniversitätMainz 1Germany