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 seve...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.展开更多
基金a grant award from Scott & White Hospital and The Texas A&M University System Health Science Center, a VA Merit Award, a VA Research Scholar Award and the NIH grants DK58411 and DK062975 to Dr. Alpini, by grant awards to Shannon Glaser and Heather Francis from Scott & White Hospital.
文摘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.
