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Transanal Endoscopic Microsurgery

Medically reviewed by Last updated on Dec 4, 2023.

What do I need to know about transanal endoscopic microsurgery (TEM)?

TEM is surgery to remove polyps or early stage cancer cells from your rectum. This surgery is done by going through your anus instead of making incisions in your abdomen.

How do I prepare for TEM?

Your healthcare provider will talk to you about how to prepare for surgery. You may need to eat low-fiber foods for 1 week before your surgery. You will need a bowel prep before surgery. A bowel prep is when you take medicine to help clean out your colon. Do not eat or drink anything after midnight on the day of your surgery. Stop taking blood thinner medicine several days before surgery as directed. You will be given an antibiotic through your IV to help prevent a bacterial infection. Tell a healthcare provider if you have ever had an allergic reaction to an antibiotic.

What will happen during TEM?

You will be given general anesthesia to keep you asleep and free from pain during surgery. Your surgeon will place a laparoscope and other small tools into your rectum. A laparoscope is a long metal tube with a light and camera on the end. Your rectum will be filled with a gas to allow your surgeon to see inside your rectum more clearly. He or she will make incisions on the wall of your rectum to remove the polyp or cancer cells. Dissolvable stitches will be used to close the incisions.

What will happen after TEM?

You will need to stay in the hospital overnight after your surgery. You may need to take antibiotics after your surgery. The gas that was used during surgery may cause you to feel bloated. You may also feel pain in your abdomen or rectum. You may have a fever for up to 24 hours after your surgery.

What are the risks of TEM?

You may bleed more than expected. Your surgeon may need to change from a TEM to an open surgery if problems occur during surgery. Your stitches may come apart, and you may get an infection. You may have trouble urinating after surgery. You may have trouble controlling gas and bowel movements for up to 6 months. Your healthcare provider may not be able to remove all the cancer cells and cancer may return. Polyps may also return.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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