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Updated: Jun 21, 2026

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Single-Port Robotic Transanal Minimally Invasive Surgery for Rectal Cancer: A Novel Approach With FishBowl-Early Case

Alfredo Mellano¹, Luca Pellegrino, Sara Salomone

¹Surgical Oncology Unit, Candiolo Cancer Institute-FPO IRCCS, Candiolo, Torino, Italy.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques

|June 19, 2026

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Transanal minimally invasive surgery (TAMIS) using the Da Vinci SP robotic platform with the novel FishBowl docking system is feasible and safe for rectal cancer excision. This SPrTAMIS approach offers ergonomic benefits and minimal patient trauma, with favorable short-term outcomes.

Area of Science:

Minimally invasive surgery
Colorectal surgery
Robotic surgery

Background:

Transanal minimally invasive surgery (TAMIS) is a validated technique for rectal adenomas and early-stage cancers.
Robotic platforms enhance surgical dexterity in confined pelvic spaces.
SP-TAMIS adoption is limited by docking constraints.

Purpose of the Study:

To report the first European series of robotic SP-TAMIS (SPrTAMIS) for rectal cancer.
To evaluate the feasibility, safety, and short-term outcomes of SPrTAMIS using a novel FishBowl docking system.

Main Methods:

Five rectal adenocarcinoma patients underwent SPrTAMIS with the Da Vinci SP system and FishBowl docking.
Procedures involved general anesthesia, CO2 pneumorectum, and robotic instrumentation.

Keywords:

FishBowl Docking System organ preservation protocols rectal neoplasm robotic surgery single-port surgery transanal endoscopic microsurgery transanal minimally invasive surgery

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Data collected included tumor characteristics, operative details, morbidity, mortality, LOS, and functional outcomes.

Main Results:

All five SPrTAMIS procedures were completed robotically without conversion.
Mean operative time was 85 minutes, with no intraoperative complications or mortality.
Patients were discharged by POD 2 with favorable short-term functional and quality-of-life outcomes.

Conclusions:

SPrTAMIS with Da Vinci SP and the FishBowl system is feasible and safe for rectal excision.
This technique offers ergonomic advantages and minimal anal canal trauma.
Further research is needed to evaluate long-term oncologic and functional results.