Transanal Endoscopic Microsurgery
Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for large polyps or small cancers that are too big to be removed by colonoscopy. It was developed in the 1980s and is offered in only a few hospitals in the United Kingdom.
The TEM device is introduced into the anus under general anaesthesia and the rectum stretched up with carbon dioxide gas. Further instruments can be introduced through the device and with the aid of a magnified, three-dimensional view, the surgeon can remove the polyp or cancer with a rim of normal surrounding tissue. The remaining defect or hole can be stitched closed.
Not all polyps are suitable for the technique and whilst more rectal cancers are being treated with TEM, an operation through the tummy to remove the bowel and its surrounding glands is more common. Sometimes patients who do undergo TEM require further treatment, including further surgery, chemotherapy or radiotherapy. The need for additional treatment is dependent on the pathologist examination under the microscope of the removed specimen.
Further information about TEM can be found here (TEM).