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UF surgeon continues quest of perfecting transanal endoscopic microsurgery of rectal tumors
University of Florida colorectal surgeon W. Robert Rout, M.D., an associate
professor of surgery, performed the first TEM, transanal endoscopic
microsurgical, resection of a rectal tumor in Florida about 15 years ago. Since
then, Rout has pioneered the use of TEM for curative or palliative treatment for
patients with benign and malignant rectal polyps.
Using a binocular operative microscope, endoscopic instruments and a specialized
video system, Rout is able to perform minimally invasive TEM on patients with
tumors—both benign and malignant—as far as 20 centimeters in the rectum.
“TEM provides surgeons a much clearer, magnified view of the operative area, and
allows for superior precision over traditional surgery,” says Rout. “The
binocular vision and video system enables us to better visualize the lesion and
obtain precise removal of the tumor.”
The primary advantage of TEM for patients is the avoidance of radical surgery
and major abdominal incisions, which reduces the morbidity and mortality
associated with major colorectal surgery. This also reduces the patient’s stay
in the hospital from several days down to 24 hours or less, depending on the
patient.
TEM is a major step in helping patients preserve their anal sphincters and often
is performed as part of a multimodality treatment program that includes adjuvant
radiation and/or chemotherapy. Thus, every case at Shands at the University of
Florida that has abnormal or cancerous tumors of the rectum is reviewed at the
weekly tumor board meeting, where a multidisciplinary team of physicians and
specialists, including medical, surgical and radiation oncologists, determine
the optimal treatment plan for each patient.
“We’re trying to make patients better without compromising their well-being, and
we’ve had satisfactory outcomes so far with low rates of tumor recurrence,” says
Rout. “In the long run, TEM is very beneficial for the patient, which is what
we’re all about.”
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