Transanal Minimally Invasive Surgery: A Useful Technique That Continues to Evolve

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Colorectal cancer is a leading cause of cancer diagnosis in the US.
• Early detection and neoadjuvant therapies are improving outcomes for rectal cancer.
• Interest is growing in local excision for organ preservation in rectal cancer.

Purpose of the Study:

• To review the technical aspects of transanal minimally invasive surgery (TAMIS) for rectal cancer.
• To discuss patient selection, preparation, and surgical techniques for TAMIS.
• To highlight recent advancements, including robotic-assisted TAMIS.

Main Methods:

• Transanal minimally invasive surgery (TAMIS) utilizes conventional laparoscopic equipment.
• TAMIS allows for full-thickness excision of rectal lesions in any quadrant.
• Robotic-assisted TAMIS leverages articulating instruments for enhanced surgical capabilities.

Main Results:

• TAMIS demonstrates superior excision quality compared to transanal excision (TAE).
• Oncologic outcomes of TAMIS are equivalent to transanal endoscopic microsurgery (TEM).
• TAMIS is a cost-effective alternative to TEM.

Conclusions:

• TAMIS is a valuable organ-preserving surgical option for selected rectal cancer patients.
• The technique offers excellent excision quality and comparable oncologic outcomes to TEM.
• Robotic platforms are enhancing TAMIS capabilities, potentially reducing the need for skilled assistants.