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Surgical Endoscopy

, Volume 33, Issue 6, pp 1981–1987 | Cite as

Laparoscopic transanal minimally invasive surgery (L-TAMIS) versus robotic TAMIS (R-TAMIS): short-term outcomes and costs of a comparative study

  • Sung G. Lee
  • Andrew J. Russ
  • Mark A. CasillasJr.Email author
2018 SAGES Oral

Abstract

Background

Transanal minimally invasive surgery (TAMIS) has gained worldwide popularity as a method for the local excision of rectal neoplasms. However, it is technically demanding due to limited working space. Robotic TAMIS offers potential enhanced dexterity and ability while allowing for a more aggressive resection with a stable platform. The objective of this study was to review a single institution experience between laparoscopic (L-TAMIS) and robotic TAMIS (R-TAMIS) for treatment of rectal neoplasms and determine if there are significant differences on outcomes.

Methods

Forty consecutive patients with rectal neoplasms underwent L-TAMIS or R-TAMIS by two colorectal surgeons from January 2012 to April 2017. We retrospectively reviewed a prospectively maintained database to analyze demographics, peri-operative data, pathology, post-operative complications, and cost.

Results

There were no significant differences between L- and R-TAMIS on patient demographics. R-TAMIS showed a statically significant increase in cost of surgery by $880. Median direct cost of L-TAMIS was $3562 compared to $4440.92 for R-TAMIS (p = 0.04). Wider range of total duration for L-TAMIS is likely due to the variability of body habitus and location of rectal neoplasm, which can significantly limit L-TAMIS compare to R-TAMIS. There was a trend toward decreased blood loss in the R-TAMIS group. Mortality was 0% in both groups.

Conclusions

After reviewing our experience, we conclude there is no significant difference between L- and R-TAMIS other than total direct cost. We confirmed that both L- and R-TAMIS are safe and associated with low morbidity. The limitations of this study include its small sample size. In the future, we hope to show promising data on R-TAMIS with increased sample size and experience, which may allow for transanal resection not previously feasible. Studies with long-term follow-up assessing oncological and functional results will be mandatory.

Keywords

Transanal minimally invasive surgery (TAMIS) Robotic TAMIS 

Notes

Acknowledgements

We thank Dr. Robert Heidel for assistance with statistical analysis.

Author contributions

Study conception and design; Acquisition of data; Analysis and interpretation of data; Drafting of manuscript; Critical revision: SGL, AJR, MAC.

Compliance with ethical standards

Disclosures

Drs. Sung Lee, Andrew Russ, and Mark Casillas, Jr. have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material Video 1 (M4V 58076 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sung G. Lee
    • 1
  • Andrew J. Russ
    • 1
  • Mark A. CasillasJr.
    • 1
    Email author
  1. 1.University of Tennessee Medical Center at KnoxvilleKnoxvilleUSA

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