Transanal Endoscopic Microsurgery (TEM)

TEM allows endoscopic visualization of the operating field using a wide-lumen rectoscope with an oblique tip. The rectoscope is anchored to the operating table using a retainer arm system to achieve stable exposure of the surgical field. The surgical procedure is carried out using a stereoscopic angled telescope which permits dissection under microsurgical conditions with 3D visualization. Up to three surgical instruments can be introduced at the same time. An additional documentation channel at the TEM stereoscope provides video transfer for the operating team. A precondition for clear dissection is distension throughout the entire operation by automatic, pressure-controlled CO2 insufflation.

Local excision with TEM offers a number of advantages compared to conventional procedures
using a retractor:

  • Local excision with the TEM system incurs minimal access trauma 
  • TEM provides operational access to the full length of the rectal canal
  • TEM stereoscope provides 3D binocular vision within the rectum 
  • CO2 distension provides an unrestricted view, beneficial during excision and suturing

Richard Wolf has a complete, refined surgical instrument set supplied for Transanal Endoscopic Microsurgery. 

Due to the complexity of the procedure, intensive training is absolutely essential for TEM. Advanced training events on this surgical procedure are held on a regular basis at the Prima Vista Richard Wolf Academy.