Transanal Endoscopic Resection of Rectal Tumours

What is transanal endoscopic resection surgery?

Transanal endoscopic resection (TER) surgery, also known as transanal endoscopic microsurgery (TEM), is a minimally invasive surgical procedure primarily used to remove benign and early-stage malignant rectal tumours. This procedure is performed through the anus using specialised instruments without the need for any abdominal incisions. Additionally, TER has been known to treat lesions that are difficult to access via conventional surgical methods.

How does transanal endoscopic resection surgery work in Singapore?

Transanal endoscopic resection surgery is usually performed under general anaesthesia in Singapore. Once the patient is ready, the procedure is performed in the following steps:

• Specialised instruments, such as a rectoscope, are inserted through the anus to access the rectum.
• Gas is pumped into the rectum for better visualisation of the tumours.
• Once your surgeon has a clear view of the location, size, and condition of the tumours, specialised surgical instruments are inserted through the rectoscope.
• The tumours or polyps, along with some of the surrounding tissue, are removed.
• After the polyps or tumours are removed, techniques such as electrocautery or suturing are used to close the resection site in the rectal wall. 

Benefits of transanal endoscopic resection

• Minimally invasive
• Quick recovery time
• Preservation of anal sphincter
• Reduced risk of complications post-procedure
• High precision and accuracy
• Shorter hospital stay
• Improved quality of life

What conditions can transanal endoscopic resection treat?

Transanal endoscopic resection treats certain types of benign rectal lesions, early-stage rectal tumours, and pre-cancerous lesions. Some of the conditions that can be treated with transanal endoscopic resection include:

• Rectal polyps
• Early-stage rectal tumours/cancer
• Pre-cancerous or recurrent lesions or growths

What results can I expect after transanal endoscopic resection surgery in Singapore?

Following the procedure, it is normal to feel some slight discomfort. You will be under observation for a few days, and may have:

• An intravenous (IV) line in your veins to give you fluids
• Another IV line for antibiotics

As with any surgery, post-procedure care is essential to ensure you heal properly. Some of the post-procedure aftercare that you need to follow are:

• Bowel movements: after the procedure, your bowel movements might change. However, it is important to maintain normal bowel movements. This includes preventing constipation, which can irritate the surgical site.
• Follow dietary restrictions: you may be placed on a restricted diet to allow your rectum to rest. This can include starting on liquid diets before gradually transitioning to solid foods.
• Limit strenuous activities: while gradually resuming normal activities is essential, it is also important to avoid strenuous activities or heavy lifting.
• Wound care: it is important to practice proper wound care to prevent infection and promote healing.

How many transanal endoscopic resection sessions are needed?

The number of transanal endoscopic resection (TER) sessions needed depends on several factors, including the size, number, and characteristics of the rectal lesions being treated, as well as the success of the initial procedure and the presence of any residual or recurrent disease. In general, the goal of TER is to achieve complete removal of the targeted lesions in a single session whenever possible.

You specialist may schedule you for a routine colonoscopy to monitor any new tumour growth. 

Frequently asked questions

What is the recovery time for transanal endoscopic resection?

Transanal endoscopic resection does not involve any abdominal incisions. It occurs entirely through the anus, and hence, recovery is more rapid compared to conventional surgery, with most individuals able to return to their daily activities quickly.

How long does transanal endoscopic resection take?

The duration of a transanal endoscopic resection (TER) procedure can vary depending on several factors, including the size, location, and characteristics of the rectal lesion being treated, as well as the complexity of the procedure. In general, however, TER procedures are relatively short and typically range from 30 minutes to 2 hours.

What are the risks associated with transanal endoscopic resection?

Although the procedure has low risks, the possibilities include bleeding, infection, rectal or abdominal pain, urinary retention, and faecal urgency.