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Indications

  • Mark H. Whiteford
Chapter

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...

Keywords

Anal Verge Transanal Endoscopic Microsurgery Natural Orifice Translumenal Endoscopic Surgery Rectal Polyp Argon Beam Coagulation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Salm R, Lampe H, Bustos A, Matern U. Experience with TEM in Germany. Endosc Surg Allied Technol 1994;2:251–54.PubMedGoogle Scholar
  2. 2.
    Smith LE, Ko ST, Saclarides T, Caushaj P, Orkin BA, Khanduja KS. Transanal endoscopic microsurgery. Initial Registry Results. Dis Colon Rectum 1996;39:S79–S84.CrossRefPubMedGoogle Scholar
  3. 3.
    Steele RJC, Hershman MJ, Mortensen NJ, Armitage NCM, Scholefield JH. Transanal endoscopic microsurgery-initial experience from three centres in the United Kingdom. Br J Surg 1996;83:207–210.CrossRefPubMedGoogle Scholar
  4. 4.
    Mentges B, Buess G, Schafer D, Manncke K, Becker HD. Local therapy for rectal tumours. Dis Colon Rectum. 1996;39:886–92.CrossRefPubMedGoogle Scholar
  5. 5.
    Saclarides TJ. Transanal Endoscopic Microsurgery: A single surgeon’s experience. Arch Surg 1998;133:595–98.CrossRefPubMedGoogle Scholar
  6. 6.
    Palma P, Freudenberg S, Samel S, Post S. Transanal endoscopic microsurgery: indications and results after 100 cases. Colorectal Dis 2004;6:350–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Cataldo PA. Transanal endoscopic microsurgery. Surg Clin N Am 2006;86:915–25.CrossRefPubMedGoogle Scholar
  8. 8.
    Lezoche E, Guerrieri M, Paganini AM, D’Ambrosio G, Baldarelli M, Lezoche G, Feliciotti F, DeSanctis A. Transanal endoscopic vs total mesorectal laparoscopic resections of T2-N0 low rectal cancers after neoadjuvant treatment: a prospective randomized trial with a 3-year minimum follow-up period. Surg Endosc 2005;19:751–756.CrossRefPubMedGoogle Scholar
  9. 9.
    Steele GD, Herndon JE, Bleday R, Russell A, Benson A, Hussain M, Burgess A, Tepper JE, Mayer RJ. Sphincter-sparing treatment for distal rectal adenocarcinoma. Ann Surg Onc 1999;6:433–41.CrossRefGoogle Scholar
  10. 10.
    Corman, ML. Carcinoma of the rectum. In: Colon and Rectal Surgery, 5th edition. Corman ML, ed. Phiadelphia: Lippincott Williams &Wilkins, 2005:905–1061.Google Scholar
  11. 11.
    Saclarides TJ, Smith L, Ko ST, Orkin B, Buess G. Transanal endoscopic microsurgery. Dis Colon Rectum 1992;35:1183–1191.CrossRefPubMedGoogle Scholar
  12. 12.
    Najarian MM, Belzer GE, Cogbill TH, Mathiason MA. Determination of the peritoneal reflection using intraoperative proctoscopy. Dis Colon Rectum 2004;47:2080–2085.CrossRefPubMedGoogle Scholar
  13. 13.
    Gavagan JA, Whiteford MH, Swanstrom LL. Full thickness intraperitoneal excision by transanal endoscopic microsurgery does not increase short-term complications. Am J Surg 2004;187:630–34.CrossRefPubMedGoogle Scholar
  14. 14.
    Luchtefeld MA, Milsom JW, Senagore A, Surrell JA, Maxier WP Colorectal anastomotic stenosis: results of a survey of the ASCRS Membership. Dis Colon Rectum 1989;32:733–736.CrossRefPubMedGoogle Scholar
  15. 15.
    Brandimarte G, Tursi A, Gasbarrini G. Endoscopic treatment of benign anastomotic colorectal stenosis with electrocautery. Endoscopy 2000;32:461–3.CrossRefPubMedGoogle Scholar
  16. 16.
    Suchan KL, Muldner A, Manegold BC. Endoscopic treatment of postoperative colorectal anastomotic strictures. Surg Endosc 2003;17:1110–3.CrossRefPubMedGoogle Scholar
  17. 17.
    Hunt TM, Kelly MJ. Endoscopic transanal resection (ETAR) of colorectal strictures in stapled anastomoses. Ann R Coll Surg Engl 1994;76:121–2PubMedGoogle Scholar
  18. 18.
    Kato K, Saito T, Matsuda M, Imai M, Kasai S, Mito M. Successful treatment of a rectal anastomotic stenosis by transanal endoscopic microsurgery (TEM) using the contact Nd:YAG laser. Surg Endosc 1997;11:485–87.CrossRefPubMedGoogle Scholar
  19. 19.
    Floyd ND, Saclarides TJ. Transanal endoscopic microsurgical resection of pT1 rectal tumors. Dis Colon Rectum 2005;49:164–8.CrossRefGoogle Scholar
  20. 20.
    ASGE/SAGES Working group on Natural Orifice Translumenal Endoscopic Surgery. White Paper. October 2005. Gastrointest Endosc 2006;63:199–203.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Mark H. Whiteford
    • 1
  1. 1.Oregon Health and Science UniversityLegacy Portland HospitalsPortlandUSA

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