Raestrup H, Manncke K, Mentges B, Buess G, Becker H D
Department of General Surgery, Eberhard-Karls University, Tuebingen, Germany.
Endosc Surg Allied Technol. 1994 Oct;2(5):241-6.
Transanal Endoscopic Microsurgery (TEM) was introduced into clinical practice by the Buess group in 1983. Since then vast experience has been gained in removing tumours of the rectum by the operative rectoscope. Though the indication in benign lesions for TEM as a local resection therapy is undisputed, the indication for resection of T1 or advanced carcinomas has to be evaluated. By using a 40 mm operating rectoscope sealed with a gastight working insert to prevent pressure loss after creation of a pneumorectum and a stereoscopic optic with sixfold magnification, exact visualisation of a rectal tumour can be achieved. The insertion of endoscopic surgical instruments like the high frequency knife, forceps, scissors, and suction device allows precise excision of the lesion as well as suture closure of the wound. Recently a bipolar multifunctional combination instrument has been developed for more precise dissection, less blood loss and shorter operation times.
经肛门内镜显微手术（TEM）于1983年由布斯团队引入临床实践。从那时起，通过手术直肠镜切除直肠肿瘤积累了丰富的经验。尽管TEM作为局部切除疗法用于良性病变的适应症毫无争议，但对于T1期或进展期癌的切除适应症仍需评估。通过使用一个40毫米的手术直肠镜，其配有气密工作插入物以防止建立气腹后压力损失，并配备六倍放大的立体光学装置，可以实现直肠肿瘤的精确可视化。插入高频刀、镊子、剪刀和吸引装置等内镜手术器械，能够精确切除病变并缝合伤口。最近，一种双极多功能组合器械已被开发出来，用于更精确的解剖、减少失血并缩短手术时间。
