Transanal Endoscopic Microsurgery

Transanal Endoscopic Microsurgery (TEM) is a specialised colorectal surgical technique used to remove polyps from the rectum. Although most polyps can be safely removed at colonoscopy, large, flat or recurrent benign polyps may be better suited to removal with TEM. It has considerable advantages over conventional transanal surgery. It is not an ideal procedure for rectal cancer or cancerous polyps.

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TEM is a minimally invasive technique akin to keyhole surgery of the rectum. The rectum is inflated with carbon dioxide gas and the polyp removed with surgical instruments inserted through the anus. The resulting defect in the rectum can be repaired with stitches.

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The procedure is performed under general anesthesia and typically takes between 45 and 90 minutes. Most patients have little or no pain afterwards and are able to be discharged from hospital the day after surgery. Bowel function may be more frequent and urgent for several weeks afterwards. Patients occasionally have temporary minor incontinence to loose stool.

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All polyps removed by TEM are submitted for examination by a pathologist. About 10% of polyps are found to contain areas of cancer, which may not have been apparent prior to TEM. Some of these patients will require additional surgery to adequately treat the cancer.

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Transanal minimally invasive surgery (TAMIS)

Transanal minimally invasive surgery (TAMIS) is an alternate platform used to remove difficult rectal polyps.