Transanal minimally invasive surgery: a giant leap forward

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Transanal endoscopic microsurgery (TEM) and single-port laparoscopy are established techniques for rectal lesion removal.
• A novel hybrid approach, TransAnal Minimally Invasive Surgery (TAMIS), combines elements of TEM and single-port laparoscopy.
• TAMIS aims to provide an effective tool for resecting both malignant and benign rectal lesions.

Purpose of the Study:

• To report the clinical application of the novel TransAnal Minimally Invasive Surgery (TAMIS) technique.
• To present preliminary data on the efficacy and safety of TAMIS for rectal lesion resection.
• To evaluate TAMIS as a feasible alternative to conventional transanal excision and TEM.

Main Methods:

• A hybrid surgical technique, TAMIS, was developed by combining transanal endoscopic microsurgery and single-port laparoscopy.
• A single-incision laparoscopic surgery port was inserted into the anal canal, establishing pneumorectum for rectal access.
• Standard laparoscopic instruments were utilized for transanal excision of rectal lesions in six patients.

Main Results:

• Six patients underwent TAMIS for rectal lesions, with no conversions to conventional techniques.
• The average operating time for TAMIS was 86 minutes, with 67% completed in under an hour, significantly less than TEM.
• Short-term follow-up revealed no observed morbidity or mortality associated with the TAMIS procedure.

Conclusions:

• TransAnal Minimally Invasive Surgery (TAMIS) is a feasible and effective alternative for rectal lesion resection.
• TAMIS offers the benefits of minimally invasive surgery at a reduced cost compared to TEM.
• The technique demonstrates potential for widespread clinical application in treating various rectal pathologies.