For more than twenty years, TEM (Transanal Endoscopic Microsurgery) has accompanied us in the world of colorectal surgery - from the first trials carried out by Professes Buess in the early 1980s until today. The TEM trend is not letting up, on the contrary, at present TEM is experiencing a real boom, and this subject is being discussed at almost all national and international congresses. New markets are being opened up for TEM (such as China – two large workshops in 2006 with Richard Wolf and Professor Buess), and the
others are being expanded continuously (such as Spain – again workshops with Richard Wolf in 2006 and in the years to come; annual courses during the congress of the American Society for Colon and Rectal Surgery, USA).
Therefore the TEM system is certainly the most successful niche product of Richard Wolf GmbH – with just under seven hundred systems sold world-wide. It is not only the instruments, but also the operating method as such that has developed into an established process in rectal surgery for certain tumour stages. The "patient benefit" is extremely high with TEM – There is hardly any other operating technique that offers more advantages for the patients than TEM.

Advantages of the TEM system compared with conventional processes

For local excision using the TEM system compared with the conventional procedures with the retractor.

• The local excision with the TEM system produces no significant access trauma. A certain overstretching of the sphincter has no consequences as a rule. Compared with the operation in which a retractor is used, the sphincter is stretched much less.
• TEM can be used in the whole rectal area.
• On account of the angulated endoscope, a good view is obtained even of the area behind the polyps. If the stereo endoscope (High-End TEM) is used, binocular sight into the entire rectum is possible.
• Using gas distension or the use of tissue elevating forceps, an almost unrestricted view is achieved. Especially when suturing considerably freer working is possible than with using just a retractor. Limited view when working with the retractor