Transanal endoscopic microsurgery (TEM) was developed by Buess in 1983 and involves the use of specialized equipment to remove selected rectal cancers and polyps . The equipment involves an operating proctoscope, insufflation, and magnified stereoscopic vision to improve visualization and facilitate more precise excision. Although there are approximately 430 TEM systems in use worldwide, there are only approximately 45 active units in the USA. Adoption of the technique of TEM has been slow in the USA probably because of the cost of the unit and the challenges of adequate training . Despite these challenges, the improved visualization and optics of TEM combined with the ability to remove lesions throughout the rectum appear to have ensured the role of TEM in the surgeon’s armamentarium. This chapter reviews the steps in beginning a TEM program, including the decision to pursue TEM equipment, training, the early experience, and the learning curve.
Deciding To Pursue Transanal...
KeywordsRectal Cancer Transanal Endoscopic Microsurgery Rectal Polyp Transanal Excision Operating Room Staff
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