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Transanal Endoscopic Microsurgery

  • M. von Flüe
Chapter

Abstract

Transanal endoscopic microsurgery (TEM) is a relatively new, minimally invasive technique for removing broad-based villous adenomas and “low-risk” carcinomas throughout the entire rectum. Using stereooptic and surgical proctoscopes, the tumor is accessible to both the eye and microsurgical instruments (Fig. 23.1). This method was developed more than 10 years ago by Buess et al. [4, 5], first in Cologne and later in Tubingen. It has now become widely established in Germany, England, the United States, and Switzerland [22–27].

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References

  1. 1.
    Adair HM, Everett WG (1983) Villous and tubulo-villous adenomas of the large bowel. J R Coll Surg Edinb 28:318–323PubMedGoogle Scholar
  2. 2.
    Banerjee AK, Jehle EC, Shorthouse AJ, Buess G (1995) Local excision of rectal tumours. Br J Surg 82:1165–1173PubMedCrossRefGoogle Scholar
  3. 3.
    Banerjie AK, Jehle EC, Kreis ME et al (1996) Prospective study of the proctographic and functional consequences of transanal endoscopic microsurgery. Br J Surg 83:211–213CrossRefGoogle Scholar
  4. 4.
    Buess GF, Mentges B (1992) Transanal endoscopic microsurgery (TEM). Minim Invasive Ther 1:101–109CrossRefGoogle Scholar
  5. 5.
    Buess G, Mentges B, Manncke K, Starlinger M, Becker HD (1992) Technique and results of transanal endoscopic microsurgery in early rectal cancer. Am J Surg 163:63–70PubMedCrossRefGoogle Scholar
  6. 6.
    Chiu YS, Spencer RJ (1978) Villous lesions of the colon. Dis Colon Rectum 22:493–495CrossRefGoogle Scholar
  7. 7.
    Christiansen J (1980) Excision of mid-rectal lesion by the Kraske sacral approach. Br J Surg 67:651–652PubMedCrossRefGoogle Scholar
  8. 8.
    Cohen AM, Wood WC, Gunderson LL, Shinnar M (1980) Pathological studies in rectal cancer. Cancer 45:2965–2968PubMedCrossRefGoogle Scholar
  9. 9.
    Cuthbertson AM, Hughes ES, Phil E (1984) Metastatic “early” colorectal cancer. Aust N Z J Surg 54:549–551PubMedCrossRefGoogle Scholar
  10. 10.
    Farin G (1993) Pneumatically controlled bipolar cutting instrument. Endoscopic surgery and allied technologies 1:97–101PubMedGoogle Scholar
  11. 11.
    Gemsenjager E (1989) Transverse pelvic floor division for the posterior approach to the rectum and anus. Int J Colorect Dis 4:67–72CrossRefGoogle Scholar
  12. 12.
    Hemingway D, Flett M, McKee RF, Finlay IG (1996) Sphincter function after transanal endoscopic microsurgical excision of rectal tumours. Br J Surg 83:51–52PubMedCrossRefGoogle Scholar
  13. 13.
    Huber AK, von Flue M (1990) Parasacral surgery for curative treatment of rectal cancer. Int J Colorect Dis 6:86–88CrossRefGoogle Scholar
  14. 14.
    Jehle EC, Starlinger MJ, Kreis ME, Buess G (1992) Alterations of anal sphincter functions following transanal endoscopic microsurgery (TEM) for rectal tumors. Gastroenterology 102:365Google Scholar
  15. 15.
    Kanehira E, Raestrup H, Schurr MO, Wehrmann M, Manncke K, Buess GF (1993) Transanal endoscopic microsurgery using a newly designed multifunctional bipolar cutting and monopolar coagulating instrument. End Surg 1:102–106Google Scholar
  16. 16.
    Mason AY (1976) Rectal cancer: the spectrum of selective surgery. Proc R Soc Med 69:237–244PubMedCentralPubMedGoogle Scholar
  17. 17.
    Mason AY (1977) Transsphincteric approach to rectal lesion. Surg Ann 6:171–194Google Scholar
  18. 18.
    Mason AY (1980) The transsphincteric approach. In: Wel-vaart R (ed) Colorectal cancer. Nijkoff, Boston, pp 171–234Google Scholar
  19. 19.
    Meissner K, Jiriskowski B, Szecsi T (1996) Der paracoccy-geale transsphinktere Zugang nach Mason: gute Ergebnisse nur bei hochselektiver Indikationsstellung? Chirurg 67:145–149PubMedGoogle Scholar
  20. 20.
    Morson BC (1966) Factors influencing the prognosis of early cancer of the rectum. Proc R Soc Med 59:607–608PubMedCentralPubMedGoogle Scholar
  21. 21.
    Parks AG, Stuart AE (1973) The management of villous tumours of the rectum. Br J Surg 60:688–695PubMedCrossRefGoogle Scholar
  22. 22.
    Saclarides TJ, Smith L, Ko ST, Orkin B, Buess G (1992) Transanal endoscopic microsurgery. Dis Colon Rectum 35:1183–1191PubMedCrossRefGoogle Scholar
  23. 23.
    Said S, Strippel D (1996) 10-jahrige Erfahrungen mit der transanalen endoskopischen Mikrochirurgie. Chirurg 67:139–144Google Scholar
  24. 24.
    Southwood WFM (1962) Villous tumours of the large intestine: their pathogenesis, symptomatology, diagnosis and management. Ann R Coll Surg Engl 30:23PubMedCentralPubMedGoogle Scholar
  25. 25.
    Steele RJC, Hershman MJ, Mortensen NJM, Armitage NCM, Scholefield JH (1996) Transanal endoscopic microsurgery-initial experience from three centres in the United Kingdom. Br J Surg 83:207–210PubMedCrossRefGoogle Scholar
  26. 26.
    Thompson BW, Tucker WE (1987) Transsphincteric approach to lesions of the rectum. South Med J 80:41–43PubMedCrossRefGoogle Scholar
  27. 27.
    von Flue M, Harder F (1994) Transanal endoskopische Mikrochirurgie: Indikation und Technik. Schweiz Med Wo-chenschr 124:1800–1806Google Scholar
  28. 28.
    Walsh RM, Ackroyd FW, Shellito PC (1992) Endoscopic resection of large sessile colorectal polyps. Gastrointest En-dosc 38:303CrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1998

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  • M. von Flüe

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