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Related Experiment Video

Updated: Oct 19, 2025

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

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Transanal endoscopic microsurgery under spinal anaesthesia.

Yael Berger1, Rachel Gingold-Belfer2, Muhammad Khatib1

  • 1Department of Surgery, Rabin Medical Center, Hasharon Hospital, Petach Tikva; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.

Journal of Minimal Access Surgery
|September 24, 2021
PubMed
Summary

Transanal endoscopic microsurgery (TEM) under spinal anesthesia is safe and effective for rectal lesions. This approach offers reduced operative time and hospital stays with no increase in complications.

Keywords:
Rectal tumorspinal anaesthesiatransanal endoscopic microsurgery

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Anesthesiology

Background:

  • Transanal endoscopic microsurgery (TEM) is a key procedure for rectal adenomas and early rectal cancer.
  • TEM is particularly valuable for patients unfit for major surgery.
  • Spinal anesthesia offers potential advantages for TEM procedures.

Purpose of the Study:

  • To evaluate the outcomes of TEM performed under spinal anesthesia.
  • To assess the safety and efficacy of this anesthetic approach in TEM.

Main Methods:

  • Retrospective collection of demographic and clinical data.
  • Analysis of 23 TEM procedures performed under spinal anesthesia between 2004 and 2015.
  • Inclusion criteria focused on patients undergoing TEM with spinal anesthesia.

Main Results:

  • 158 TEM procedures were reviewed; 23 were under spinal anesthesia.
  • Mean patient age was 69.1 years; lesions included adenomas and early adenocarcinoma.
  • No anesthesia-related adverse events; reduced post-operative pain; median hospitalization of 2 days; all surgical margins were tumor-free.

Conclusions:

  • TEM under spinal anesthesia is associated with short surgical duration.
  • This approach does not increase operative or post-operative complications.
  • It offers a viable alternative for patients unsuitable for general anesthesia.