This minimally invasive surgical technique was invented and developed by Dr. Gerhard Buess at the University of Tubingen in Germany in conjunction with Richard Wolf. The TEM instrumentation set produced by Wolf is designed to resect and suture full thickness lesions in the rectum. A special insufflation pump allows the surgeon to operate from inside the rectum to remove rectal tumors and adenomas at distances of up to 20cm from the anal verge. This permits select patients to avoid major abdominal surgery.

Dr. John Marks runs a T.E.M. training center out of the Lankenau Institute for Medical Research outside of Philadelphia, in Wynnewood, PA. This is one of two centers in the United States and is run in conjunction with Wolf.

Drs. John H. and Gerald J. Marks are the North American representatives in a European based trial for the treatment of rectal cancer, comparing T.E.M. with chemotherapy and radiation therapy to major abdominal surgery.