Less invasive surgeries

Transanal endoscopic microsurgery (TEM)

For some patients with localized early stage rectal cancer, a surgical procedure known as Transanal Endoscopic Microsurgery (TEM) could be an option.

This approach is especially suited for older patients with medical conditions that make it difficult to go through surgery or those who prefer not to have abdominal surgery due to the danger of ending up with permanent colostomy.

A specially designed magnifying endoscope goes through the anus into the rectum. This allows the surgeon to do a transanal (through the anus) resection (surgical removal of part of an organ or structure) with high precision.

This is a much less invasive procedure, minimizing any complications associated with surgery, reducing the recovery time and preserving the neighboring nerves associated with urinary control and sexual function. Even more important, patients treated with TEM avoid a colostomy.

It is done under general or partial anesthesia and lasts, typically, about 2 hours, compared to the 3-4 hours ofa standard abdominal surgery. The length of hospital stay is also shorter.

However, this is a very specialized procedure suited only for very early stages of cancer. It also requires unique equipment and surgeons with special training and experience.