Transanal Endoscopic Microsurgery is a minimally invasive procedure that allows us to remove large rectal polyps or/ and early rectal cancer without the need for major resection.

The procedure is performed through the rectum, with the use of an endoscopic platform.

The risk of complications is minimal, in comparison with major resections and the tumour or the polyp can be excised full thickness. Post-operative pain is minimal and patient usually returns home the same day. It is a technically demanding procedure that should be performed only by trained colorectal surgeons.



The most common indications are large rectal polyps that cannot be removed with a colonoscopy and early rectal cancer that need full thickness excisions

Some limitations are inadequate views and retraction and the distance from a.v, but can be overcomed with proper training.

An algorithm in the management of rectal lessions can be seen below.



The most frequent used platforms are the TEMS, TEO and the TAMIS platform

The TAMIS platform is a single-incision, low profile, multiport device, which allows for a flexible set up. The procedure is performed with laparoscopic or robotic instruments and energy source and needs minimally invasive surgical skills as  we have to work in a very confined space and  parallel choreography

It is FDA approved and usually the GelPOINT Path (Applied Medical) is used.

The SILS Port (Medtronic) can be used as well. It is more suitable for low and mid rectal lesions, but not  for very low lesions









The predictors of residual disease in ERC  is polyp site, size and morphology, resection margin, depth of invasion, lymphovascular invasion and differentiation.

For details, please contact us.