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Updated: Nov 7, 2025

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Robotic TAMIS: A Technical Note Comparing Si® versus Xi®.

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|May 4, 2021
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Summary

Robotically assisted transanal minimally invasive surgery (R-TAMIS) enhances rectal surgery safety and maneuverability. This technique improves suture closure and reduces injury risks, particularly with the da Vinci Xi system.

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Area of Science:

  • Surgical Technology
  • Robotic Surgery
  • Minimally Invasive Procedures

Background:

  • Transanal minimally invasive surgery (TAMIS) facilitates rectal defect repair.
  • Robotic assistance (R-TAMIS) can further optimize TAMIS procedures, especially for anterior rectal wall closure.

Purpose of the Study:

  • To describe a technique for robotically assisted transanal minimally invasive surgery (R-TAMIS).
  • To highlight safety considerations and compare robotic platforms (da Vinci Si vs. Xi) for R-TAMIS.

Main Methods:

  • Port insertion onto the GelPOINT® Path Transanal Access Platform prior to rectal insertion.
  • Utilizing ports of varying lengths to minimize external collision.
  • Employing an AirSeal™ port for stable pneumorectum insufflation.
  • Comparing da Vinci Si and Xi patient cart designs and their impact on surgical positioning and maneuverability.

Main Results:

  • The described technique enhances safety by reducing rectal injury risk and port collision.
  • The da Vinci Xi system offers improved patient positioning and greater maneuvering freedom compared to the Si system.
  • Specific design differences (arm mounting, arm circumference, movement patterns) between Si and Xi impact surgical workflow and safety.

Conclusions:

  • R-TAMIS is a safe and feasible technique for rectal surgery.
  • Careful consideration of port placement, instrument selection, and robotic platform choice is crucial for optimizing R-TAMIS outcomes.
  • The da Vinci Xi system presents advantages over the Si system for R-TAMIS due to its ergonomic design.