title: [Video-assisted transanal endoscopic microsurgery of rectal tumours - V-TEM].
abstract: BACKGROUND
  Transanal endoscopic microsurgery (TEM) has become increasingly established as the method of choice for the local resection of endoscopically unresectable rectal adenomas and early-stage, low-risk rectal carcinomas. Multiple studies have shown that the single port-technique TEM results in significantly less trauma with comparable overall treatment outcome as compared to conventional radical surgical techniques. However, TEM is not widely used due to high initial set-up costs, the need for highly complex equipment and demanding surgical skill requirements.
  
  
  METHODS
  To mitigate these challenges we have successfully developed a video-assisted TEM (V-TEM) method, which resulted in approximately 50 % lower initial set-up costs through the introduction of simplified original TEM surgical equipment. Between October 2003 and September 2011 we have completed 103 resections using the V-TEM method.
  
  
  RESULTS
  The observed rates of complications and local recurrences are comparable to reported rates.
  
  
  CONCLUSIONS
  We were able to mitigate the challenges of TEM through the establishment of the technically less demanding V-TEM method, which resulted in approximately 50 % lower initial set-up costs while maintaining overall treatment outcomes.
authors.affiliation: Klinik für Allgemein-, Thorax- und Gefäßchirurgie, Ostalb-Klinikum Aalen, Aalen, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Huschitt
authors.affiliation: Klinik für Allgemein-, Thorax- und Gefäßchirurgie, Ostalb-Klinikum Aalen, Aalen, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Strauß
authors.affiliation: Klinik für Allgemein-, Thorax- und Gefäßchirurgie, Ostalb-Klinikum Aalen, Aalen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Plaksin
authors.affiliation: Klinik für Allgemein-, Thorax- und Gefäßchirurgie, Ostalb-Klinikum Aalen, Aalen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Siech
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D059032:Learning Curve; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology; D009367:Neoplasm Staging; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D020535:Video-Assisted Surgery / Q000379:methods*