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Related Experiment Videos

Indications and technique for TEM (transanal endoscopic microsurgery)

H Raestrup1, K Manncke, B Mentges

  • 1Department of General Surgery, Eberhard-Karls University, Tuebingen, Germany.

Endoscopic Surgery and Allied Technologies
|October 1, 1994
PubMed
Summary

Transanal Endoscopic Microsurgery (TEM) offers precise rectal tumor removal using specialized instruments. Its effectiveness is clear for benign lesions, but its role in T1 or advanced carcinomas requires further evaluation.

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Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Procedures
  • Surgical Oncology

Background:

  • Transanal Endoscopic Microsurgery (TEM) was developed in 1983 for rectal tumor resection.
  • Extensive experience exists for TEM in removing rectal tumors via an operative rectoscope.
  • The established indication for TEM is local resection of benign rectal lesions.

Purpose of the Study:

  • To evaluate the role and indication of Transanal Endoscopic Microsurgery (TEM) in treating T1 or advanced rectal carcinomas.
  • To review the technical aspects and outcomes of TEM for rectal tumor resection.

Main Methods:

  • Utilizes a 40 mm operating rectoscope with a gastight insert for pneumorectum.
  • Employs stereoscopic optics with sixfold magnification for precise tumor visualization.

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  • Incorporates endoscopic surgical instruments including a high-frequency knife, forceps, scissors, and suction device for lesion excision and wound closure.

    • Main Results:

    • Achieves exact visualization of rectal tumors.
    • Enables precise excision of lesions and subsequent suture closure of the wound.
    • Recent advancements include a bipolar multifunctional instrument for improved dissection, reduced blood loss, and shorter operation times.

    Conclusions:

    • TEM is undisputed for local resection of benign rectal lesions.
    • The indication for TEM in T1 or advanced rectal carcinomas warrants further evaluation.
    • Technological advancements enhance the precision and efficiency of TEM procedures.