Use of a SILS port in transanal endoscopic microsurgery in the setting of a community hospital.

Transanal endoscopic microsurgery (TEM) is a well-known technique for the removal of rectal lesions. This operation poses several advantages over traditional anal excision, which include better visibility of the rectum, more precise border excision, and a lower recurrence rate of benign and stage T1 malignant neoplasms. Introducing a SILS™ port (Covidien) into the anal canal (originally developed for single-incision laparoscopic surgery), instead of the TEM proctoscope, may further enhance the technique. We performed excisions of rectal lesions in 3 patients using a SILS port in TEM. In all cases, it was easy to maintain the rectum insufflated, and the visibility was excellent. The rectal lesions were successfully resected without significant intraoperative complications. Postoperative recovery was uneventful in both cases. TEM with a SILS port is a promising technique that may provide several advantages over the traditional TEM, including cost-effectiveness, and can be easily implemented in the setting of a community hospital.