Name of the Procedure:

Excision of Rectal Tumor, Transanal Approach; Not Including Muscularis Propria (Partial Thickness) (Common Names: Transanal Local Excision)

Summary

In this procedure, a rectal tumor is removed through the anus without cutting through the deeper muscle layers. It is a minimally invasive technique aimed at removing the tumor in a less traumatic way.

Purpose

The procedure is done to remove rectal tumors that are superficial and do not involve the deeper layers of the rectum. The main goal is to eradicate the tumor while preserving as much normal tissue as possible, thus minimizing complications and facilitating a quicker recovery.

Indications

• Small, early-stage rectal tumors.
• Patients with benign tumors or early malignant tumors that have not invaded deeper layers.
• Ideal for patients where deeper excision is not advisable due to health concerns.

Preparation

• Patients may be instructed to fast prior to the procedure.
• A bowel preparation may be required to clear the intestines.
• Preoperative diagnostic tests such as colonoscopy, MRI, or CT scan to assess the tumor size and location.
• Discussion of current medications and possible adjustments, particularly blood thinners.

Procedure Description

1. The patient is positioned to allow access to the rectum.
2. Anesthesia or sedation is administered for comfort.
3. The surgeon inserts instruments through the anus to reach the tumor.
4. Using specialized tools, the tumor is carefully excised, avoiding the deeper muscle layers.
5. The excised tissue is retrieved for pathological examination to confirm complete removal and to assess the nature of the tumor.

Duration

The procedure typically takes 1 to 2 hours, depending on the size and location of the tumor.

Setting

The procedure is performed in a hospital or an outpatient surgical center.

Personnel

• A colorectal surgeon
• An anesthesiologist
• Surgical nurses and possibly a surgical technician

Risks and Complications

• Bleeding
• Infection
• Incomplete removal of the tumor
• Recurrence of the tumor
• Damage to surrounding tissues

Benefits

• Minimally invasive with a shorter recovery time.
• Preservation of rectal function.
• Lesser risk of complications compared to more invasive surgeries.
• Quick relief from symptoms related to the tumor.

Recovery

• Post-procedure monitoring for several hours.
• Pain management with prescribed medications.
• Instructions on dietary modifications and activity restrictions for a few days.
• Follow-up appointments to monitor recovery and ensure the tumor was completely removed.
• Pathology report discussion to plan further treatment if necessary.

Alternatives

• Traditional surgical excision which involves deeper tissue removal.
• Endoscopic mucosal resection (EMR).
• Radiation therapy or chemotherapy for tumors that are not ideal for surgical removal.
• Pros and cons of each alternative based on effectiveness, recovery time, and patient health status.

Patient Experience

• The procedure itself is performed under anesthesia, so the patient does not feel pain.
• Some discomfort or mild pain post-procedure, managed with medication.
• Full recovery typically within a few weeks, depending on individual health and procedure specifics.
• Close follow-up care to monitor for recurrence and manage any post-surgical complications.