Transanal minimally invasive surgery - A single-center experience

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures
• Surgical Oncology

Background:

• Transanal minimally invasive surgery (TAMIS) has been established for a decade, requiring laparoscopic skills and gaining global acceptance.
• It is versatile, applied to rectal polyp and cancer excisions with favorable outcomes.
• This study evaluates TAMIS outcomes in a large district general hospital setting.

Purpose of the Study:

• To assess the safety and efficacy of Transanal minimally invasive surgery (TAMIS) in a district general hospital.
• To evaluate TAMIS for various rectal conditions, including benign polyps and early-stage rectal cancer.
• To determine the feasibility of day-case TAMIS procedures.

Main Methods:

• A retrospective analysis of prospectively collected data from 52 consecutive TAMIS procedures performed between May 2014 and February 2020.
• Data included patient demographics, diagnoses, operative details, pathology, excision adequacy, and complications.
• Follow-up adhered to national post-polypectomy guidelines.

Main Results:

• TAMIS was successfully completed in 50 of 52 patients (96.5%) with no conversions. Indications included polyps and emergency bleeding control.
• Histology revealed mostly benign polyps (46 cases) with 11 malignant cases; 77.5% of lesions had complete excision with negative margins.
• The median follow-up was 20 months with no reported complications or mortality; 64% of patients were discharged the same day.

Conclusions:

• Transanal minimally invasive surgery (TAMIS) is a safe and feasible option in district general hospitals for benign and early rectal cancers.
• TAMIS effectively managed post-polypectomy bleeding and completed rectal polypectomies.
• Day-case TAMIS is a safe and viable option for selected patients.