Transanal Endoscopic Video Assisted Rectal Lesion Resection, New Techniques Addressing Neoplasms
- 1 Division of Minimally Invasive Surgery, Department of Surgery, University of Texas at Houston Medical School, Houston, USA
- 2 Division of Minimally Invasive Surgery, Department of Surgery, University of Texas at Houston Medical School, Houston, USA
- 3 Division of Minimally Invasive Surgery, Department of Surgery, University of Texas at Houston Medical School, Houston, USA
- 4 Colorectal Surgical Associates, Sugar Land, USA
Abstract
Early rectal cancer beyond the reach of conventional instruments has resulted in major abdominal and pelvic operations. As visualization is compromised beyond 6 - 8 cm, proximal to the anal verge, there have been several innovations and techniques to address T1 or T2 rectal cancer in the mid to upper rectum. Transanal Endscopic Microsurgery (TEM) was a technique that had garnered some success, however with expensive instrumentation along with limitations in instrument mobility, this technology was not applicable to many patients. Transanal Endoscopic Video Assisted (TEVA) rectal resection offers a cheap and readily accessible media to address early rectal cancer. Any hospital with standard laparoscopic ability is capable to offer TEVA rectal resection. We do advocate appropriate patient selection and advise that there is a learning curve with the increased requirement for technical difficulty. Once mastered, however, this surgical approach does provide yet another tool in the armamentarium of the surgeon.
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