Successful treatment of a rectal lesion by transanal endoscopic microsurgery with the ultrasonically-activated scalpel

Summary

We report the advantages of using transanal endoscopic microsurgery (TEM), with an ultrasonically-activated scalpel (UAS) for the treatment of a rectal lesion. A 66 year old woman was admitted to our hospital with a rectal tumour. A barium enema and colonoscopy revealed that the rectal tumour had a diameter of 1.5 cm. It was located approximately 4.0 cm from the dentate line. An endoscopic polypectomy was performed transanally. Pathologic examination revealed that the tumour was a rectal cancer with pT1 invasion. Additional surgical treatment was required, due to the possibility that unresected cancer was still located at the surgical margin. Endoscopic treatment was performed, using UAS under TEM. The entire rectal wall was fully resected. There were no intraoperative or post-operative complications. We conclude that TEM is a safe and minimally invasive procedure. Furthermore, UAS is very effective for endoscopic surgery. To our knowledge this is the first report of the successful use of this novel procedure.

Keywords:

• rectal lesion
• transanal endoscopic microsurgery (TEM)
• ultrasonically activated scalpel (UAS)