Transanal minimally-invasive surgery (TAMIS): Technique and results from an initial experience

Abstract

Transanal endoscopic microsurgery is a minimally-invasive approach for rectal lesions. Superior exposure and access to the entire rectum result in lesser risk of compromised margins and lower recurrence rates, when compared to conventional transanal excision. The aim of this study was to describe a single institution's initial experience with transanal minimally invasive surgery (TAMIS). This was a prospective review of our database. Eleven procedures from January 2012 to June 2013 were analyzed. Results eleven operations were completed. Five men were evaluated. Mean age was 62.9 (40-86). Mean follow-up was 9.3 (2-17) months. Average tumor size was 3.8 (1.8-8) cm. Mean distance from anal verge was 6.3 (3-12) cm. Mean operating time was 53.73 (28-118) min. Postoperative complication rate was 9.1%. There were no readmissions. Mortality was null. Operative pathology disclosed the presence of adenoma in four patients, invasive adenocarcinoma in two, neuroendocrine carcinoma in three, and no residual lesion in one case. TAMIS is a minimallyinvasive procedure with low postoperative morbidity at the initial experience. TAMIS is a curative procedure for benign lesions and for selected early cancers. It is useful after neoadjuvant therapy for strictly selected cancers, pending the results of multi-institutional trials.

Transanal Endoscopic Proctectomy: a new approach to the total excision of the mesorectum

“…Today, for this procedure there are several ways to a perineal approach with TEO and TAMIS. 23,24 In these studies, their authors proved that the use of the several tools equipment found in the market to carry out TAMIS is viable, and this is true also for the equipment for TEO.…”

What Is the Comparative Efficacy of Surgical, Endoscopic, Transanal Resection, and Radiotherapy Modalities in the Treatment of Rectal Cancer?

“…In addition, while comparing transanal resection, each has its advantages and considerations. Transanal resection, such as TEM or TAMIS (Transanal Minimally Invasive Surgery), offers the potential for organ preservation and shorter recovery time compared to more extensive surgical procedures [27]. Radiotherapy, particularly when combined with chemotherapy, is often employed in locally advanced cases to improve local control and increase the chances of successful surgical resection [28].…”

Robotic transanal surgery: perspectives for application

“…Peritoneal entry represents a well-known complication of TAMIS and it is described more frequently when tumors are located anteriorly in the middle or upper rectum [12] . When it occurs (1% of cases [12] ), it is recommended to use a steep Trendelenburg position to facilitate wall repair and to convert to laparoscopy if it is impossible to maintain an adequate pneumorectum [22][23][24] . With this regard, some authors suggest placing the patients in a prone position to limit the amount of CO 2 passing into the peritoneal cavity [25] .…”