Transanal techniques have long been used for management of rectal diseases. Transanal local excision of rectal tumors was popularized by Parks et al. in the 1950s and is well suited for the management of selected low rectal lesions. Removal of lesions in the middle and upper rectum presents a more challenging problem owing to the limited accessibility and inadequate exposure afforded by standard instrumentation. These more proximal lesions have traditionally been managed by low anterior, abdominoperineal, transsacral, and transsphincteric resections. The transanal endoscopic microsurgery (TEM) operating system now offers a low morbidity and often outpatient alternative to these more radical surgical options.
TEM allows greater versatility and options for the operating surgeon. In addition to extending the surgeon’s reach up to the distal sigmoid colon, the four ports of access allow for synchronous use of an illuminated camera, forceps, cautery, suction as well as the freedom to use...
KeywordsAnal Verge Transanal Endoscopic Microsurgery Natural Orifice Translumenal Endoscopic Surgery Rectal Polyp Argon Beam Coagulation
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