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Transanal endoscopic microsurgery is a form of minimally invasive surgery where the surgeon accesses the site, usually somewhere in the rectum, through the anus. There are a number of benefits to this approach when it is an available option, including shorter healing time and more patient comfort during healing. However, the number of procedures for which transanal endoscopic microsurgery is appropriate are very limited, and it may not be available in all locations because many surgeons do not have the necessary training.
This is a form of laparoscopic surgery, where a surgeon enters the body through a very small incision, inserts a camera and other tools, and then inflates the area with gas to separate tissues and make it easier to see. In such procedures, doctors can take biopsy samples, remove growths, treat strictures, drain abscesses, and so forth, all without the need for an open incision.
In transanal endoscopic microsurgery, the surgeon uses the anus as a point of entry, while the patient is under general anesthesia for comfort. She will then manipulate the surgical tools to reach the site of interest and perform the procedure. In the event that she cannot complete the procedure transanally, she can convert to an open surgery with an incision to open up the surgical site and access it directly. The chances of needing to convert to an open procedure vary, and should be discussed before surgery.
After transanal endoscopic microsurgery, patients can usually resume regular activities very quickly. The healing time is brief, and surgical pain is minimal. Often, patients can control it with basic analgesic medications they may be able to buy at a pharmacy, although prescription pain relief is available for the first few days. Limited pain makes surgical recovery much more pleasant and reduces complications, like the risk of blood clots due to inactivity.
If a patient is a candidate for transanal endoscopic microsurgery, the doctor will discuss it and provide information. Patients should ask about how long a surgeon has been practicing, and what kind of training he has received in this specific procedure. They may also want to ask about risks and benefits when compared to other surgical techniques. It is also helpful to ask more generally about the goal of the surgery, how the surgeon will evaluate the outcome, and what kind of additional treatment, such as chemotherapy for cancer, to expect after surgery. This can help patients plan more effectively.