Transanal Endoscopic Microsurgery (TEM)

As an 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.

Our ability to remove rectal lesions transanally is limited by access and exposure, with conventional instruments usually restricting the surgeon to the distal six to seven centimeters of rectum. When transanal excision is not possible, the traditional transabdominal approach - a major surgical procedure - is necessary.

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.

Transanal endoscopic microsurgery (TEM), with its longer reach and enhanced visibility of the entire rectum, extends the boundaries of transanal surgery, giving appropriately selected patients a minimally invasive surgical option with a faster and virtually pain-free recovery.


Advantages of Transanal Endoscopic Microsurgery (TEM)

With TEM, the colorectal surgeon has a longer reach and better visibility into the rectum. With TEM paitents benefit from the following:

  • TEMNo abdominal incision
  • Less bleeding
  • Less risk of infection and complications
  • Less risk of bowel obstructions post-surgery
  • Shorter hospital stay
  • Faster recovery and return to normal activities

Dr. Domingo Galliano in the news!


General Surgery

Board Certified by the American Board of Surgery


Colon and Rectal Surgery

Board Certified by the The American Board of Colon and Rectal Surgery (ABCRS)


Surgical Critical Care

Board Certified by The American Board of Surgery


Dr. Galliano is the most experienced Board Certified Colorectal Surgeon with Da Vinci Robotic Surgery in Lee, Charlotte, Sarasota, and De Soto Counties! He has performed over 100 DaVinci Robotic procedures!


Minimally Invasive Procedures

Experience less pain, minimal scarring, faster recovery, and better results.


Robotic Surgery
via Da Vinci


Laparoscopic Surgery


FENIX for Accidental Bowel Leakage (ABL)


TEM Transanal Endoscopic Microsurgery


NOSCAR/ NOTES Painless Natural Orifice Trans-endoscopic Surgery


Solesta is a sterile gel injected into the anus to treat the symptoms of fecal incontinence.


Esophyx long-term incisionless solution for chronic acid reflux GERD


The LINX System stops acid reflux (GERD) at the source.


The Stretta procedure results in significant GERD symptom control and patient satisfaction.


STARR Staple Transanal Rectal Resection


ENTERRA -- Gastric Electrical Stimulation for Gatroparesis


Barrx - Radiofrequency Ablation in Barrett's Esophagus with Dysplasia


TIF Transoral Incisionless Fundoplication procedure corrects the root cause of GERD


ABS - Artificial Bowel Sphincter


SECCA - for incontinence


Sacral Nerve Stimulation


Anorectoplasty for anal incontinence


Pelvic rehabilitation for incontinence and constipation, anal / pelvic pain


Anal Fistula Plug