TEM: Transanal Endoscopic Microsurgery
TAMIS: Transanal Minimally Invasive Surgery
TEM is a special technique to remove tumors throughout the rectum. TEM provides magnified
vision and superior optics.
TAMIS is a special technique to remove tumors from the upper part of the rectum. TAMIS
provides magnified vision and superior optics.
Follow these steps to clean your bowel before surgery. Please note that “Clear” means no
sediment, it does not mean colorless.
2 days before surgery, eat breakfast but then drink only clear liquids.
Clear Jell-O® (no fruit in it)
homemade from box only
Water or soda
Broth or bouillon
Juice with no pulp (apple, grape, no orange)
Weak coffee or tea, no creamer – sugar is OK
Gatorade® or other clear sports drinks
Gatorade® Recover 3 (14 grams of protein)
No alcohol or dairy products
Try to drink at least one bottle of Gatorade® Recover 3 each day for 2 days before surgery. Mix
GoLYTELY® with warm drinking water to top of line on bottle and shake. It will be clear. Do
not add flavor to this. Store this in the refrigerator. Use within 48 hours. Okay to add Crystal
Light® powder mix to flavor each glass.
1 day before surgery, drink only clear liquids all day.
9am: Take 4 bisacodyl tablets with water. Do not chew or crush. Do not take within 1
hour of taking an antacid or other morning medicine. It is okay to do this step earlier in
As soon as you have a bowel movement, start to drink the GoLYTELY®. Drink 1 8oz
glass every 10 minutes until half the bottle is gone – or your stools are clear. If you
see sandy particles in the toilet water, drink a cup at a time until they are gone and it looks
clear. Do not sip slowly. It works better if you drink quickly.
1 hour after you finish the GoLYTELY®, take the 1st dose of antibiotics.
3-4 hours later, take the 2nd dose of antibiotics.
At 10 pm, take the last dose of antibiotics.
You should keep drinking clear liquids until bedtime. Shower before going to bed.
Morning of surgery (at least 1 hour before leaving home)
Give yourself a Fleets® phosphate enema. Shower again.
Note: You may feel some cramps in your lower abdomen while drinking the GoLYTELY®. If
you have steady stomach pain, get light-headed and dizzy, do not have any bowel movements at
all or can’t drink the GoLYTELY®, call the clinic at 608-890-5000. This is a 24 hour number.
After hours and on weekends ask for the doctor on call or for Dr. _______________________.
Tell them your problem.
Toll free number: 1-855-342-9900
Do not take any of your scheduled medicines for 1 hour before or after drinking the bowel
prep as they will not be absorbed.
1. Take a sitz bath at least three to four times a day and after each bowel movement for two
days and then as needed for comfort. A sitz bath is sitting in warm water to decrease pain
and spasms. You can use a portable sitz bath that fits on your toilet or sit in the bathtub.
Sit in the water for at least 10 – 20 minutes.
2. For the first few days, after a bowel movement gently clean with warm water. You may
want to use baby wipes.
3. You may have yellowish-red drainage from the rectum for at least 7 – 14 days. Sanitary
pads in your underwear can prevent soiling. The drainage will become less and become
lighter in color over time. You can expect more bloody drainage after a bowel
movement, with increased activity, and after 10 days when the sutures begin to dissolve.
Do not lift more than 20 pounds until it is okayed by your doctor.
Change your position from sitting, standing and lying as needed for comfort
Do not drive while taking narcotic pain pills.
Sexual activity may be resumed when okayed by your doctor.
ξ Talk with your doctor before you return to work. Your time off depends on what you do.
At first, you will feel pressure rather than pain. Or you may feel like you need to get to the
bathroom fast. This is normal and will improve with time. You will have pain pills if needed.
Diet after Surgery
Plan to eat a low fiber diet for the first few weeks with stool softeners (docusate sodium). Refer
to chart on the last page. This will help to avoid bulky stool stretching the incision. After
2 – 3 weeks, you may increase the fiber in your diet. This can include a bulk fiber laxative like
Metamucil®. Your doctor will talk to you about your diet.
Be sure to drink at least 8-10 (8 oz.) glasses of fluid a day. Fluids with caffeine do not count.
When to Call the Doctor
Problems having a bowel movement
Unable to control bowel movements
Increased pain and bleeding with bowel movements
Large amounts of bright red blood that does not stop with pressure applied to the area for
Temperature greater than 100.4 θ F. Take your temperature once a day for 1 week
Pain not controlled by pain pills
Problems passing urine
Digestive Health Center: (608) 890-5000 Monday – Friday, 8am – 5pm
After hours, weekends or holidays this number will be answered by the paging operator.
Ask for the doctor on call for Dr. ________________. Leave your name and phone number with
area code. The doctor will call you back.
If you live out of the area, call (855) 342-9900.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 6/2015 University of Wisconsin Hospitals &
Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7002
Low Fiber Diet
Food Group Foods Recommended Foods to Avoid
Breads, Grains, Pastas, Rice White breads, rolls, biscuits, muffins, and crackers without
seeds and nuts, White Rice, White Pasta
Bread or pasta made with whole grains or bran. Any product made
with seeds, dried fruit, coconut, or nuts. Brown rice, Wild rice.
Check food labels and avoid any products with more than 2 grams
of fiber per serving.
Cereals Check labels on cereal boxes and choose cereals with less
than 1 grams of fiber/serving, such as corn flakes or rice
krispies. Refined cooked cereals limited to ½ cup servings:
cream of wheat, farina, and quick cooking oatmeal.
Whole grain or bran cereals. All cereal with more than 1 gram fiber
per serving. Granola, Cereal bars
Fruits: ½ c servings Apples and apricots peeled, Avocado ripe, Banana (1/2 ),
ripe Cherries, sweet Mandarin oranges, Melons, Peaches
Dried fruits, All other fruits that are high in fiber such as all
berries, dates, figs, pears, whole oranges, prunes.
Vegetables: fresh, frozen, or
canned- ½ c servings
Asparagus tips, cooked, Carrots, cooked, Cucumber,
peeled and seeded, Lettuce, tender leaf lettuce, Potatoes,
peeled and cooked, Sweet potatoes, cooked, Winter
squash, cooked, Zucchini, peeled and seeded
Beans and Lentils
Beans: kidney, garbanzo, black, navy, and pinto beans. Soy beans,
Meats, Poultry, Fish Tender meats, poultry and fish that are cooked. Meat, poultry, fish that are fried. Tough meats/ meats with gristle.
Meat products made with whole grains, nuts, or seeds such as some
sausages or lunch meats. Soy meat substitutes such as Boca
Eggs Eggs, cooked in any way
Dairy Milk, cheese, yogurt, sour cream, and any dairy products as
Dairy products with added nuts, seeds, or fruits.
Beverages Coffee and tea, Cocoa, Carbonated beverages, Fruit juices
without pulp (except prune juice)
Prune juice. Smoothies made with fruits or grains
Fats Butter and margarine, Vegetable oil, Olive oil, Meat
gravies. Salad dressings made without fruits, nuts, or seeds
Any fats or salad dressings with added fruits, dried fruits, seeds, or
Desserts and Sweets Sugar, honey, molasses, Jelly, Sherbet, frozen yogurt, ice
cream, popsicles without fruits, seeds, or nuts. Cookies,
pastries, pies, puddings, custards, and candy without fruit,
seeds, or nuts.
Jams, preserves, and marmalade. Any made with fruit, dried fruit,
nuts, seeds, or coconut.
Miscellaneous Salt, pepper, ketchup, mustard, vinegar, herbs, & spices as
tolerated, Cream sauces, Smooth peanut butter/nut butters,
limited to 1 T. / serving
Nuts, seeds, Olives, Pickles. Soups, casseroles & all mixed dishes
made with high fiber fruits, vegetables, or grains.