Diseases of the Colon & Rectum

, Volume 35, Issue 12, pp 1183–1191 | Cite as

Transanal endoscopic microsurgery

  • Theodore J. Saclarides
  • Lee Smith
  • Sung-Tao Ko
  • Bruce Orkin
  • Gerhard Buess
Current Status


Transanal endoscopic microsurgery (TEM) has emerged as a minimally invasive means of resecting rectal tumors. Developed in Germany and now being used with increasing frequency in the United States, TEM utilizes a 40-mm operating rectoscope, which is sealed with an airtight facepiece. Carbon dioxide is constantly infused, thereby distending the rectum and maintaining visibility. A variety of instruments, such as tissue graspers, a high-frequency knife, suction, and needle holders, are inserted through the facepiece. Adenomas that are small, large, or even circumferential, as well as selected carcinomas up to 24 cm, can be removed with TEM instrumentation. The optics provide sixfold magnification, and this, combined with the constantly distended operative field, allows for a precise excision of the tumor as well as closure of the wound. For lesions in the mid and upper rectum, TEM is an alternative to a transsacral or transabdominal approach, with subsequently shorter hospital stay and fewer complications.

Key words

Transanal resection Minimally invasive Rectal neoplasms 


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Copyright information

© American Society of Colon and Rectal Surgeons 1992

Authors and Affiliations

  • Theodore J. Saclarides
    • 1
  • Lee Smith
    • 2
  • Sung-Tao Ko
    • 1
  • Bruce Orkin
    • 2
  • Gerhard Buess
    • 3
  1. 1.Department of General Surgery, Section of Colon and Rectal SurgeryRush-Presbyterian- St. Luke's Medical CenterChicago
  2. 2.Section of Colon and Rectal SurgeryGeorge Washington UniversityWashington, D.C.
  3. 3.Eberhard-Karls UniversitaetTubingenGermany

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