Transanal Endoscopic Microsurgery

Abstract
LOCAL EXCISION of rectal neoplasms is an accepted method of treating selected lesions and can be accomplished through either a transanal approach or a posterior proctotomy. The former is hindered by poor exposure and visibility of lesions in the middle and upper rectum. While the latter approach does give somewhat improved exposure of these more cephalad tumors, it may be complicated by fecal fistulae or sphincter impairment. Transanal endoscopic microsurgery (TEM) has emerged as a better technique for removing lesions in the middle and upper rectum, and it obviates the need for a posterior proctotomy.1-4

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