Surgical Innovations
TEMS for Rectal Tumors
An alternative to major abdominal surgery
Fine instrumentation is used to remove tumors during transanal endoscopic microsurgery, sparing patients from major abdominal surgery.
CREDIT: Richardwolf Medical Instruments Corporation |
Until recently, many patients with precancerous growths or early cancers of the rectum had to undergo open surgery with a long recovery period and risks of complications.
Now, a new addition to the surgeon’s toolkit, transanal endoscopic microsurgery (TEMS), can eliminate the need for major surgery for many of these patients.
Patients with precancerous growths or early cancers of the rectum traditionally have had two options for removal, one entailing a major abdominal operation to remove the diseased part of the rectum, and the other, surgery to remove the lesion through the anus.
For small growths near the anal opening, the second, less invasive method may suffice, but it does not work for lesions that are larger or not conveniently located, according to Daniel Feingold, MD, Section Director of Clinical Trials, Colon and Rectal Surgery.
"Many patients, even those with benign lesions, have had to undergo high-risk, open abdominal operations."
Daniel Feingold, MD |
Now, recent publications have documented the feasibility and safety of removing benign and early cancerous growths through the anus using transanal endoscopic microsurgery, or TEMS.
This minimally invasive method uses specially designed instruments to remove small and large lesions through the anal opening.
Dr. Feingold is very pleased to have this surgical option available to patients, because it allows his team to remove lesions that are large or that are located far from the anal opening.
New to Columbia in 2007, TEMS is not yet widely available in the U.S., despite its clear benefits of less trauma and faster recovery.
In contrast with the open abdominal operation that requires a week to ten days in the hospital and a six-week recovery period, TEMS leaves patients with no skin incision and very little pain after surgery.
Most leave the hospital 24-48 hours after surgery and experience very short rec overy periods.
In addition to allowing the surgeon to access tumors high up in the rectum that would otherwise not be accessible to transanal methods, TEMS affords significantly improved visualization, according to Dr. Feingold.
"It is often difficult to obtain an adequate view of the tumor using conventional transanal surgery, but the magnified video image in TEMS provides an excellent view of the lesion and permits minimally invasive excision."
TEMS is not appropriate for patients with advanced rectal cancers unless they are ineligible for abdominal surgery, but for patients with benign or precancerous lesions, TEMS can eliminate the need for major surgery.
For more information, please call 800.227.2762.
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