London Marathon Raises Money for Bowel Research UK
We are immensely proud of our colorectal and peritoneal surgeon Mr Umar Shariff, who ran the London Marathon this year...
Transanal Endoscopic Microsurgery (TEMS) is an innovative surgical approach to treating tumours high up inside the rectum (lower part of the large intestine). This safe, minimally-invasive procedure has a lower risk of complications and faster recovery rates than conventional rectal cancer surgery.
Whereas previously the surgeon would have had to perform open surgery (making a large incision along the abdomen), TEMS allows them to reach this part of the bowel without making any kind of incision. Instead, a small instrument called a rectoscope is gently inserted into your bottom and the surgeon can then pass tiny surgical instruments and a camera through it to reach your rectum.
The advantage of this type of surgery is that there is no surgical incision which reduces the risk of infection, bowel obstruction and other complications. Recovery times are quicker and there is a shorter stay in hospital. Patients undergoing TEMS experience lower blood loss and less pain that with conventional open surgery.
Our team, led by Stephan Korsgen and Deepa Bapu, use TEMS to treat selected patients with early rectal cancers (T1 and early T2) as well as those with a polyp in the bowel that is too large to remove with colonoscopy. Sometimes TEMS is also used alongside radiotherapy.
Prior to surgery, the surgeon may use endorectal ultrasound to show the size and location of the tumour inside the rectum. During an endorectal ultrasound scan, you lie on your side with your knees bent up. The doctor will insert a small ultrasound probe into your back passage, which will reveal images on the computer screen and allow them to pinpoint the cancer.
On the day of your TEMS surgery you will be given a laxative to completely empty out your bowels. You will be given a general anaesthetic so you will be asleep throughout the procedure, which involves inserting the rectoscope into your back passage. This will be filled with gas to give the surgeon a clear view of the tumour and small surgical instruments will be inserted through the rectoscope to remove the tumour and a small amount of surrounding tissue.
You will normally stay in hospital for one to two days after transanal endoscopic microsurgery, during which time you will be given intravenous antibiotics and fluids. It normally takes a few days to recover and you may have liquid bowel movements for several weeks after the procedure.
Patients with early stage (T1 to T3b) cancer of the rectum may be interested in participating in the TREC and STAR-TREC trials which research whether radiotherapy or a combination of radiotherapy and chemotherapy are as good as standard treatment at combatting early stage rectal cancer.
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