Peking Union Medical College Hospital pioneered transanal endoscopic microsurgery (TEM), a groundbreaking technique for treating rectal tumors. This method involves inserting a 4 cm-wide proctoscope through the anus into the rectum, allowing surgeons to access the surgical area via four channels on the device. Equipped with stereoscopic mirrors and specialized instruments, doctors can perform precise tumor removal under a microscope. TEM was first developed by German experts in 1983 and has since become a standard procedure in many Western countries and Japan.
In China, the technology was introduced to Hong Kong in 1995 but remained largely unexplored until recently. Traditional methods for rectal tumor treatment include transanal resection for tumors close to the anus and laparotomy for those further away. Both approaches carry risks, such as high trauma, long recovery times, and potential complications. The hospital’s earlier transanal sphincter approach showed some success but still involved significant surgical trauma.
Compared to traditional surgery, TEM offers several advantages. First, it is minimally invasive, requiring no skin incisions and preserving the anal function in patients who might otherwise need a colostomy. Second, it allows for accurate tumor removal from any distance along the rectum, ensuring clear margins and reducing the risk of recurrence. Third, the operation typically takes about an hour, with minimal blood loss and no need for transfusions. Fourth, the risk of postoperative complications is lower due to the precision and reduced trauma. Fifth, it enables the collection of high-quality tissue samples for accurate pathological analysis. Lastly, patients recover faster, with shorter hospital stays and quicker return to daily activities.
The Department of Basic Surgery and Colorectal Surgery at Peking Union Medical College Hospital has extensive experience in colorectal cancer treatment, with over 95% of patients being specifically referred for such conditions. Since April this year, eight successful TEM procedures have been performed, with all patients recovering well and showing no complications. One notable case involved a 70-year-old patient who had recurring rectal polyps and early-stage cancer. Instead of undergoing a traditional open surgery, he was treated using TEM, resulting in a quick recovery and early discharge.
TEM requires highly skilled surgeons, as the procedure is performed on a flat plane, unlike laparoscopic techniques. Surgeons must be trained to operate using a TV monitor or stereoscopic lenses and must have strong backgrounds in traditional rectal surgery. With its growing adoption, TEM represents a major advancement in the field of colorectal surgery, offering safer, more effective treatment options for patients.
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