Transanal Local Excision of Rectal Lesions (TEMS, TAMIS, TAE)

Abstract

This chapter describes the detailed steps for a transanal local excision of rectal lesions. The conventional transanal excision (TAE) has significant limitations, but several different platforms (transanal endoscopic microsurgery, TEMS; transanal minimally invasive surgery, TAMIS) have evolved to improve visualization and reach. The essential aspect for favorable outcomes remains patient selection. The local approach spares properly selected patients a more invasive oncological resection with its potential morbidity and mortality and remains the treatment of choice for benign lesions of the rectum. For invasive cancer, however, the risk of local recurrence is increased. This chapter gives details of indications, preoperative preparation, pitfalls and danger points, operative strategy and technique, postoperative care, and complications.