Transanal Endoscopic Microsurgery

Advanced transanal excision techniques facilitate surgical excision of benign and early-stage malignant rectal lesions. Transanal endoscopic microsurgery (TEM) is advantageous over endoscopic resection techniques because of the ability to perform full-thickness rectal wall excision and a higher rate of en bloc resection with tumor-free margins. TEM is, however, limited by the long and challenging learning curve, the high instrumentation costs, and the relatively limited number of patients suitable for the procedure.