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Transanal Endoscopic Microsurgery (TEM)

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Book cover Minimally Invasive Coloproctology

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Abstract

Surgery of the rectum is difficult, as it is located within the confines of the narrow bony pelvis. This precludes good lighting and good exposure. With the proximity of nerve plexuses and venous plexuses to the pelvic organs, it is very demanding to attain good oncological surgery with optimal functional outcomes. Transanal endoscopic microsurgery (TEM) is a form of minimally invasive surgery developed by Buess et al. in 1984 as a means of local resection of early rectal tumor (T0, Tis, and low risk T1). It is a technically demanding local resection, operating through the anus, and avoiding any skin incision. It may not be an overstatement to say that TEM is actually the “Minimally Invasive Surgery of Minimally Invasive Surgery” in rectal operation.

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References

  1. MacFarlane JK, Ryall RDH, Heald RJ. Mesorectal excision for rectal cancer. Lancet. 1993;341:457–60.

    Article  CAS  PubMed  Google Scholar 

  2. Cheung HYS, Ng KH, Leung ALH, Chung CC, Li MKW. Laparoscopic sphincter-preserving total mesorectal excision: 10-year report. Colorectal Dis. 2011;13:627–31.

    Article  CAS  PubMed  Google Scholar 

  3. Cho KR, Vogelstein B. Genetic alterations in the adenoma-carcinoma sequence. Cancer. 1992;70:1727–31.

    Article  CAS  PubMed  Google Scholar 

  4. Speake D, Biyani D, Frizelle FA, Watson AJM. Flat adenoma. ANZ J Surg. 2007;77:4–8.

    Article  PubMed  Google Scholar 

  5. Yashiro M, Carethers J, Laghi L, et al. Genetic pathways in the evolution of morphologically distinct colorectal neoplasms. Cancer Res. 2001;61:2676–83.

    CAS  PubMed  Google Scholar 

  6. Richter H, Slezak P, Walch A, Werner M, Braselmann H, Jaramillo E, Ost A, Hirata I, Takahama K, Zitzelsberger H. Distinct chromosomal imbalances in non-polypoid and polypoid colorectal adenomas indicate different genetic pathways in the development of colorectal neoplasms. Am J Pathol. 2003;163:287–94.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Boland CR, Goel A. Microsatellite instability in colorectal cancer. Gastroenterology. 2010;138:2073–87.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Muto T, Bussey HJR, Morson BC. The evolution of cancer of the colon and rectum. Cancer. 1975;36(6):2251–70.

    Article  CAS  PubMed  Google Scholar 

  9. Neugut AI, Johnsen CM, Forde KA, Treat MR. Recurrence rates for colorectal polyps. Cancer. 1985;55:1586–9.

    Article  CAS  PubMed  Google Scholar 

  10. Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopicpolypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993;329:1977–81.

    Article  CAS  PubMed  Google Scholar 

  11. Edge SB, Byrd DR, Compton CC, et al., editors. AJCC cancer staging manual. 7th ed. New York: Springer; 2010. p. 143–64.

    Google Scholar 

  12. Kikuchi R, Takano M, Takagi K, et al. Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum. 1995;38:1286–95.

    Article  CAS  PubMed  Google Scholar 

  13. Buess G, Theiss R, Gunther M, Hutterer F, Pichlmaier H. Endoscopic surgery in the rectum. Endoscopy. 1985;17:31–5.

    Article  CAS  PubMed  Google Scholar 

  14. Meng WCS, Shao CX, Lau PYY, Yip AWC. Transanal endoscopic microsurgery for excision of rectal tumors. Chin J Gastrointest Surg. 2003;6:96–8.

    Google Scholar 

  15. Langer C, Markus P, Liersch T, Fuzesi L, Becker H. UltraCision or high-frequency knife in transanal endoscopic microsurgery (TEM)? Advantages of a new procedure. Surg Endosc. 2001;15(5):513–7.

    Article  CAS  PubMed  Google Scholar 

  16. Marks JH, Valsdottir EB, DeNittis A, Yarandi SS, Newman DA, Nweze I, Mohiuddin M, Marks GJ. Transanal endoscopic microsurgery for the treatment of rectal cancer: comparison of wound complication rates with and without neoadjuvant radiation therapy. Surg Endosc. 2009;23(5):1081–7.

    Article  PubMed  Google Scholar 

  17. Banerjee AK, Jehle EC, Kreis ME, et al. Prospective study of the proctographic and functional consequences of transanal endoscopic microsurgery. Br J Surg. 1996;83(2):211–3.

    Article  CAS  PubMed  Google Scholar 

  18. Meng WCS, Lau PYY, Yip AWC. Treatment of early rectal tumours by transanal endoscopic microsurgery in Hong Kong: prospective study. Hong Kong Med J. 2004;10:239–43.

    CAS  PubMed  Google Scholar 

  19. National Comprehensive Cancer Network, Cancer, rectum. Retrieved on 1/3/2014. http://www.nccn.org

  20. Gall FP, Hermanek P. Update of the German experience with local excision of rectal tumours. Surg Oncol Clin North Am. 1992;1:99–109.

    Google Scholar 

  21. Marks JH, Nassif G, Schoonyoung H, DeNittis A, Zeger E, Mohiuddin M, Marks G. Sphincter-sparing surgery for adenocarcinoma of the distal 3 cm of the true rectum: results after neoadjuvant therapy and minimally invasive radical surgery or local excision. Surg Endosc. 2013;27:4469–77.

    Article  PubMed  Google Scholar 

  22. Meng WCS, Wong CS. Feasibility study on single-port access (SPA) laparoscopic cholecystectomy using transanal endoscopic microsurgery (TEM) instruments. Minim Invasive Ther Allied Technol. 2010;19(6):364–6.

    Article  PubMed  Google Scholar 

  23. Lezoche E, Guerrieri M, Paganini AM, Feliciotti F. Long-term results of patients with pT2 rectal cancer treated with radiotherapy and transanal endoscopic microsurgical excision. World J Surg. 2002;26(9):1170–4.

    Article  PubMed  Google Scholar 

  24. Bökkerink GMJ, de Graaf EJ, Punt CJA, Nagtegaal ID, Rutten H, Nuyttens JJME, et al. The CARTS study: chemoradiation therapy for rectal cancer in the distal rectum followed by organ-sparing transanal endoscopic microsurgery. BMC Surg. 2011;11:34.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Heald RJ, Moran BJ, Ryall RDH, Sexton R, MacFarlane JK. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978–1997. Arch Surg. 1998;133:894–9.

    Article  CAS  PubMed  Google Scholar 

  26. Heald RJ. A new solution to some old problems: transanal TME. Tech Coloproctol. 2013;17:257–8.

    Article  CAS  PubMed  Google Scholar 

  27. Meng W, Lau K. Synchronous laparoscopic low anterior and transanal endoscopic microsurgery total mesorectal resection. Minim Invasive Ther Allied Technol. 2014;23(2):70–3.

    Article  PubMed  Google Scholar 

  28. Palanivelu C, Rangarajan M, Jategaonkar PA, Anand NV. An innovative technique for colorectal specimen retrieval: a new era of “natural orifice specimen extraction” (N.O.S.E). Dis Colon Rectum. 2008;51(7):1120–4.

    Article  PubMed  Google Scholar 

  29. Leung AL, Cheung HY, Li MK. Advances in laparoscopic colorectal surgery: a review on NOTES and transanal extraction of specimen. Asian J Endosc Surg. 2014;7(1):11–6.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Matilda International Hospital, Hong Kong, China

    William Chia Shing Meng MBChB, FRCSEd, FHKAM, FACS, MD

Authors
  1. William Chia Shing Meng MBChB, FRCSEd, FHKAM, FACS, MD
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Corresponding author

Correspondence to William Chia Shing Meng MBChB, FRCSEd, FHKAM, FACS, MD .

Editor information

Editors and Affiliations

  1. Department of Surgery, Matilda International Hospital, HongKong, China

    William C S Meng

  2. Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China

    Hester Y S Cheung

  3. City Medical Center Room 833, 8/F, Office Tower 1, Grand Plaza, Hong Kong, China

    David T Y Lam

  4. Department of Surgery, Prince of Wales Hospital The Chinese University of Hong Kong, Hong Kong, China

    Simon S M Ng

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© 2015 Springer International Publishing Switzerland

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Meng, W.C.S. (2015). Transanal Endoscopic Microsurgery (TEM). In: Meng, W., Cheung, H., Lam, D., Ng, S. (eds) Minimally Invasive Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-319-19698-5_11

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  • DOI: https://doi.org/10.1007/978-3-319-19698-5_11

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19697-8

  • Online ISBN: 978-3-319-19698-5

  • eBook Packages: MedicineMedicine (R0)

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