TEM is emerged as an trans anal alternative to more radical abdominal surgery, Transanal Endoscopic Microsurgery (TEM) offers a minimally invasive solution for the excision of certain rectal polyps and early stage rectal tumors. Pioneered in 1983 by German surgeon, Dr. Gerhard Buess, TEM has revolutionized the resection of rectal lesions. Performed transanally with specially designed microsurgical instrumentation, TEM has made it possible to excise lesions high inside the rectum that otherwise would be accessible only by major abdominal surgery. The patient benefits of TEM as compared to radical abdominal surgery are clear: no major surgery, no large incision, no colostomy, less pain, faster recovery and shorter hospital stay.