Medical Policy Transanal Endoscopic Microsurgery

1. Technology Assessment: Transanal endoscopic microsurgery (TEM) is a minimally invasive surgical technique that was developed to avoid the morbidity of radical surgery for adenomas and early-stage rectal cancer, while still allowing for complete removal of the lesion. TEM requires specialized instrumentation. TEM uses a natural opening (the anus) to reach the target organ, and is a valuable surgical technique with a low complication rate for patients with appropriate rectal lesions. The main advantages of TEM are preservation of the rectum, anus and fecal continence, low complication rates, short operation times, lower blood loss, shorter hospital stays, and shorter recover times. Other advantages include better exposure, magnified stereoscopic view, and greater reach into the middle and upper rectum.