Transanal surgery for rectal cancer

Transanal surgery is a procedure used to remove small, early-stage rectal cancers through the anus without making an incision. During the procedure, your surgeon inserts a videoscope—a thin, flexible instrument equipped with a three-dimensional camera and light at the end into the anus. This enables them to view a video monitor to see the inside of the rectum and to use a cutting instrument to remove the tumor. This minimally invasive method allows patients to keep their bowel function and can mean easier recovery and reduced complication risks.

Transanal surgery is performed by colorectal cancer surgeons (formerly called proctologists) with expertise in treating diseases of the colon, rectum, and anus. Penn Medicine offers nationally recognized colorectal cancer care for anal canal cancers, providing minimally invasive treatment options such as laparoscopic and robotic surgeries for rectal tumors.

Your Penn Medicine clinician may recommend the TAE surgery if you have early-stage rectal cancer that’s close to the anus opening but hasn’t spread to the anus or sphincter.

If your early-stage cancer is located too high in the rectum for TAE, or if you have multiple health conditions that prevent open abdominal surgery, your provider may recommend the TEM surgery.

You may be a candidate for the TaTME surgery if you have a low rectal tumor. Your provider may also recommend the TaTME surgery if you are at higher risk for a permanent colostomy bag, especially if you are obese, have a narrow pelvis, or were assigned male at birth.

Before your procedure, your care team will provide instructions on how to completely empty and cleanse your bowels, ensuring your surgeon has a clear view of your rectum. The preparation is like what you would undergo prior to a colonoscopy. You may be asked to take a laxative for a few days, avoid consuming solid foods, and restrict your diet to clear liquids. Plan to remain at home during the bowel preparation.

Because transanal surgery avoids opening the abdomen, unlike traditional surgeries for rectal cancer, recovery from transanal surgery is typically immediate, with most patients being discharged within 24 hours. Your Penn Medicine provider may observe you for a brief period, and they’ll share any necessary post-procedure instructions. You may experience some mild discomfort or temporary incontinence lasting a few days.

Your provider will discuss the results of the transanal surgery with you and may recommend further evaluation or treatment based on the findings.

Our surgeons are leaders in the videoscopic techniques used in rectal cancer treatment. This includes endoscopy and laparoscopy, which rely on the use of small fiberoptic cameras attached to thin, flexible tubes to generate images from inside the body onto a television monitor. We are also leaders in researching and testing new minimally invasive surgeries, and in offering training in videoscopic techniques to other surgeons nationwide.

Penn Medicine rectal surgeons and team members are recognized nationally and internationally for their clinical, scientific, and educational contributions. All have completed fellowship training in rectal surgery and are board-certified by the American Board of Surgery and the American Board of Colon and Rectal Surgery.