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Transanal Endoscopic Microsurgery (TEM)

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Minimally Invasive Cancer Management

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Abstract

The ultimate minimally invasive procedure for intra-abdominal neoplasia is one that avoids any abdominal incision. To this end, colonoscopy with polypectomy meets the criteria and stands as the first major step in minimally invasive therapy of colorectal neoplasia. NOTES (Natural Orifice Translumenal Endoscopic Surgery) holds open the promise for just such an approach. To date the only large experience in this type of natural orifice therapy is with transanal excision of rectal polyps and select rectal cancers. Unfortunately, limited reach transanally has significantly hampered this approach. TEM has addressed this problem. Nonetheless, limited experience of surgeons has impeded the widespread adoption of this approach. In addition, concerns about the adequacy of oncologic treatment of a rectal cancer with a full-thickness excision have properly minimized acceptance of this approach. High local recurrence rates using a transanal approach have been attributed to the inability to reach the cephalad aspect of the cancer’s margin, working within the lumen potentially spreading viable cancer cells and the untreated lymphatic space.

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Author information

Authors and Affiliations

  1. Marks Colorectal Surgical Associates, Wynnewood, USA

    John H. Marks MD (Co-Director, Assistant Professor of Clinical Surgery, Senior Investigator)

  2. MCP-Hahnemann University, Wynnewood, USA

    John H. Marks MD (Co-Director, Assistant Professor of Clinical Surgery, Senior Investigator)

  3. Lakenau Institute for Medical Research, Wynnewood, USA

    John H. Marks MD (Co-Director, Assistant Professor of Clinical Surgery, Senior Investigator)

  4. Department of Surgery, Lakenhau Hospital, Wynnewood, PA, 19096, USA

    John H. Marks MD (Co-Director, Assistant Professor of Clinical Surgery, Senior Investigator)

Authors
  1. John H. Marks MD
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Editors and Affiliations

  1. Medical Center, Dept. Surgery, Carolinas Health Care System, Blythe Boulevard 1000, Charlotte, 28203, North Carolina, USA

    Frederick L. Greene

  2. Medical Center, Dept. Surgery, Carolinas Health Care System, Blythe Boulevard 1000, Charlotte, 28203, North Carolina, USA

    B. Todd Heniford

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© 2009 Springer Science+Business Media, LLC

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Marks, J.H. (2009). Transanal Endoscopic Microsurgery (TEM). In: Greene, F., Heniford, B. (eds) Minimally Invasive Cancer Management. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1238-1_16

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  • DOI: https://doi.org/10.1007/978-1-4419-1238-1_16

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-1237-4

  • Online ISBN: 978-1-4419-1238-1

  • eBook Packages: MedicineMedicine (R0)

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