A Modified Buess Rectoscope for TEM

Objective of the technology. TEM (Transanal Endoscopic Microsurgery) is a minimally invasive endoscopic technique, which offers excellent access and visualization of the surgical field, improving the quality of local excision for rectal lesions with full-thickness excision of the rectal wall. We have modified the Buess rectoscope in order to improve the quality and versatility of the device.

Description of the technology. The standard operative Buess rectoscope comes in 2 sizes, of 12 or 20 cm. By shortening the length down to 5 cm, we have obtained three targets. First, the lower rectal wall above the anal canal can be easily accessed. Second, the instrument has more lateral space for wider movements. Third, the device, which is considered the first single port introduced in the surgical practice, can be used in the abdomen as well, with the same multiuse instruments, widening its applications.

Preliminary results. The new device has been tested in the rectal wall. We have performed 2 transanal resection of large benign polypoid lesions. The resection of the distal margin was easier to perform. The quality of the suturing of the defect has also improved.

Conclusions. Indications for local excision of rectal lesions are widening. There are several devices available in the market. The Buess rectoscope, was the first to be introduced more than 20 years ago, and over the years has been modified several times. We believe that with this modification its versatility will further improve.

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