Trans-anal minimally invasive surgery: A new technique to avoid peritoneal entry

Dufresne, Anne-Marie; Withers, Rebecca; Ramkumar, Jonathan; MacKenzie, Shawn; Melich, George; Vikis, Elena

doi:10.1016/j.ijscr.2018.09.029

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…These techniques are not suitable for addressing any type of tumor or lymphogenic metastatic disease. All transanal resection techniques are performed under general endotracheal anesthesia, which entails morbidity and mortality and requires appropriate preoperative preparation 17 .…”

Section: Discussionmentioning

confidence: 99%

“…Although TAMIS is slightly more challenging to perform in cases of high lesion localization, from 10 to 15 cm from the anorectal line, the surgery is less invasive, entails lower treatment costs, and requires a shorter hospitalization period compared to TAE and TEMS. In addition to these advantages, there are other benefits such as easier handling of equipment, and use of existing laparoscopic equipment familiar to surgeons, resulting in faster surgeon training to master this technique 14,15,17,18 . Despite these advantages, in certain cases, difficulties may arise during TAMIS procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Ove tehnike nisu adekvatne za rešavanje bilo kog tipa tumorske ili limfogene metastatske bolesti. Sve tehnike transanalne resekcije izvode se u opštoj endotrahealnoj anesteziji koja ima za posledicu morbiditet i mortalitet i zahteva odgovarajuću preoperativnu pripremu 17 .…”

Section: Diskusijaunclassified

“…Iako je TAMIS u slučajevima visoke lokalizacije lezije, od 10 do 15 cm od anokutane linije, malo teža za izvođenje, operacija je manje invazivna, manji su troškovi lečenja i zahteva kraći period hospitalizacije u odnosu na TAE i TEMS. Osim navedenih prednosti, prisutne su i neke druge, kao što je lakše rukovanje opremom, korišćenje već postojeće opreme za laparoskopiju sa kojom su hirurzi već familijarni, pa je i obuka hirurga za ovladavanje ovom tehnikom brža 14,15,17,18 .…”

Section: Diskusijaunclassified

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Local radical treatment of pathological lesions of the rectum with minimally invasive surgical approaches

Stevanović,

Mitrović,

Jašarović

et al. 2024

Galenika Med J

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Introduction: The most common pathological changes treated in the rectum are neoplastic polyps (villous, tubular, and tubulovillous adenomas) and rectal adenocarcinomas. Until now, precancerous lesions of the type of neoplastic polyps have been treated with a local approach, and patients with advanced cancers have been operated on with a radical surgical intervention, either classically or laparoscopically. Aim: In this paper, we will show the advantages and disadvantages of certain local surgical approaches to pathological changes in the rectum. Material and methods: Our research analyzed two groups of patients. In the first group, patients with pathological lesions of the rectum were treated with local transanal excision (TAE), and the second group of patients were treated with the newly introduced technique of transanal minimally invasive surgery (TAMIS). In the period from September 2021 to March 2023. at the CHC Zemun in Surgery Clinic, a total of 12 patients were operated on with the TAMIS procedure and 15 patients with the TAE technique for various pathological changes in the rectum. In all patients, the changes were localized in the rectum from 5 to 15 cm from the anocutaneous line in the TAMIS group and from 0 to 6 cm in the TAE group. Pathological changes could not be resected by endoscopic polypectomy. Results: The average duration of the operations was longer in the TAMIS group and amounted to 45 minutes, while the operations lasted an average of 20 minutes in the TAE group. During the surgical procedure, mucosectomy is most often performed, followed by resection of the full thickness of the rectal wall, and resection of the rectal wall with part of the mesorectal tissue was performed the least frequently in both analyzed groups. In 3 patients we had preparation fragmentation, and in 1 case we had positive margins by histopathological postoperative analysis in the TAMIS group. In the TAE group, we had one patient with preparation fragmentation and a positive margin. Patients with a positive margin in both the TAE and TAMIS groups belonged to villous adenomas with a high degree of dysplasia. The final HP finding in both groups most often spoke in favor of tubulovillous adenoma with a low to medium degree of dysplasia. In both groups, we had 2 cases of early intramucosal carcinoma T1 stage. Discussion: The postoperative period of hospitalization is shorter in TAE compared to TAMIS (1.3 days compared to 1.8 days). We had no serious postoperative complications in any of the observed groups. In one case, we had postoperative bleeding, which was treated with endoscopic hemostasis. Such low percentages of postoperative complications, even in our small series of patients, justify the introduction of the TAMIS procedure into daily practice for the surgical treatment of large endoscopically unresectable rectal polyps of high rectal localization. Conclusion: Based on our work and the available literature, we can conclude that radical local resections of TAE and TAMIS are a viable alternative to surgical radical rectal resection in polypoid changes and early T1 rectal cancers with less morbidity, faster recovery, and lower treatment costs. These techniques are safe, effective, and reproducible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Diskusijaunclassified

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Local radical treatment of pathological lesions of the rectum with minimally invasive surgical approaches

Stevanović,

Mitrović,

Jašarović

et al. 2024

Galenika Med J

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“…Not surprisingly, partial excision will lead to significant positive margins, which translates to loco regional recurrence [20] . Dufresme et al [21] described the usage of a laparoscopic stapler for excision of high rectal sessile polyps as an approach to prevent peritoneal breech. However, the evidence supporting this approach is only backed by a short series of five cases.…”

Section: Safety and Feasibilitymentioning

confidence: 99%

Transanal minimally invasive surgery: how can it help us?

Sriram¹,

Tzu-Liang²

2020

MIS

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Transanal surgery has evolved significantly in the past few decades. With the technological advancements of endoscopic systems, minimally invasive approaches in transanal surgeries are quickly increasing in popularity. Transanal endoscopic microsurgery was developed initially with subsequent transanal minimally invasive surgery (TAMIS) being introduced as an alternative in 2009. Over the past decade, more and more papers have been published on TAMIS, regarding the management of benign/malignant rectal lesions as well as repair of anastomotic leaks, anastomotic strictures, rectovaginal/rectourethral fistula, etc. This review details the progress of transanal surgery and the use of TAMIS in different scenarios.

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