SUCCESSFUL TREATMENT OF A RECTAL LESION BY TRANSANAL ENDOSCOPIC MICROSURGERY WITH THE ULTRASONICALLY-ACTIVATED SCALPEL

We report the advantages of using transanal endoscopic microsurgery (T EM), with an ultrasonically activated scalpel (UAS) for the treatment of a rectal lesion. A 66 year old woman was admitted to our hospital w ith a rectal tumour. A barium enema and colonoscopy revealed that the rectal tumour had a diameter of 1.5 cm. It was located approximately 4 .0 cm from the dentate line. An endoscopic polypectomy was performed t ransanally. Pathologic examination revealed that the tumour was a rect al cancer with pT1 invasion. Additional surgical treatment was require d, due to the possibility that unresected cancer was still located at the surgical margin. Endoscopic treatment was performed, using UAS und er TEM. The entire rectal wall was fully resected. There were no intra operative or pest-operative complications. We conclude that TEM is a s afe and minimally invasive procedure. Furthermore, UAS is very effecti ve for endoscopic surgery. To our knowledge this is the first report o f the successful use of this novel procedure.