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Journal of Gastrointestinal Surgery

, Volume 20, Issue 2, pp 463–469 | Cite as

Transanal Minimally Invasive Surgery: State of the Art

  • D. S. Keller
  • E. M. Haas
Review Article

Abstract

The treatment for rectal cancer and benign rectal lesions continues to progress in the arena of minimally invasive surgery. While surgical excision of the primary mass remains essential for eradication of disease, there has been a paradigm shift towards less invasive resection methods. Local excision is increasing in popularity for its low morbidity and excellent functional results in select patients. Transanal minimally invasive surgery (TAMIS) is a new technology developed to elevate the practice of local excision to state-of-the-art resection. The goal of this article is to evaluate the history, short-term outcomes, and evolution of the TAMIS technique for excision of benign and malignant rectal neoplasia.

Keywords

Rectal cancer Transanal minimally invasive surgery TAMIS Transanal excision Local excision 

Notes

Compliance with Ethical Standards

Funding

The authors received no funding or support for this project.

Conflict of Interest

The authors declare that they have no competing interests.

References

  1. 1.
    Heafner TA, Glasgow SC. A critical review of the role of local excision in the treatment of early (T1 and T2) rectal tumors. J Gastrointest Oncol. 2014;5:345–352.PubMedCentralPubMedGoogle Scholar
  2. 2.
    Allaix ME, Fichera A. Modern rectal cancer multidisciplinary treatment: the role of radiation and surgery. Ann Surg Oncol. 2013;20:2921–2928.CrossRefPubMedGoogle Scholar
  3. 3.
    Bentrem DJ, Okabe S, Wong WD et al. T1 adenocarcinoma of the rectum: transanal excision or radical surgery? Ann Surg. 2005;242:472–7; discussion 477–9.PubMedCentralPubMedGoogle Scholar
  4. 4.
    Blumberg D, Paty PB, Guillem JG et al. All patients with small intramural rectal cancers are at risk for lymph node metastasis. Dis Colon Rectum. 1999;42:881–885.CrossRefPubMedGoogle Scholar
  5. 5.
    Endreseth BH, Myrvold HE, Romundstad P, Hestvik UE, Bjerkeset T, Wibe A. Transanal excision vs. major surgery for T1 rectal cancer. Dis Colon Rectum. 2005;48:1380–1388.CrossRefPubMedGoogle Scholar
  6. 6.
    Madbouly KM, Remzi FH, Erkek BA et al. Recurrence after transanal excision of T1 rectal cancer: should we be concerned? Dis Colon Rectum. 2005;48:711–9; discussion 719–21.CrossRefPubMedGoogle Scholar
  7. 7.
    Chakravarti A, Compton CC, Shellito PC et al. Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation. Ann Surg. 1999;230:49–54.PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    You YN, Baxter NN, Stewart A, Nelson H. Is the increasing rate of local excision for stage I rectal cancer in the United States justified?: a nationwide cohort study from the National Cancer Database. Ann Surg. 2007;245:726–733.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Stitzenberg KB, Sanoff HK, Penn DC, Meyers MO, Tepper JE. Practice patterns and long-term survival for early-stage rectal cancer. J Clin Oncol. 2013;31:4276–4282.PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Neary P, Makin GB, White TJ et al. Transanal endoscopic microsurgery: a viable operative alternative in selected patients with rectal lesions. Ann Surg Oncol. 2003;10:1106–1111.CrossRefPubMedGoogle Scholar
  11. 11.
    Middleton PF, Sutherland LM, Maddern GJ. Transanal endoscopic microsurgery: a systematic review. Dis Colon Rectum. 2005;48:270–284.CrossRefPubMedGoogle Scholar
  12. 12.
    Benson ABr, Bekaii-Saab T, Chan E et al. Rectal cancer. J Natl Compr Canc Netw. 2012;10:1528–1564.Google Scholar
  13. 13.
    Casadesus D. Surgical resection of rectal adenoma: a rapid review. World J Gastroenterol. 2009;15:3851–3854.PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Demartines N, von Flue MO, Harder FH. Transanal endoscopic microsurgical excision of rectal tumors: indications and results. World J Surg. 2001;25:870–875.CrossRefPubMedGoogle Scholar
  15. 15.
    Moore JS, Cataldo PA, Osler T, Hyman NH. Transanal endoscopic microsurgery is more effective than traditional transanal excision for resection of rectal masses. Dis Colon Rectum. 2008;51:1026–30; discussion 1030–1.CrossRefPubMedGoogle Scholar
  16. 16.
    Fucini C, Segre D, Trompetto M. Local excision of rectal polyp: indications and techniques. Tech Coloproctol. 2004;8 Suppl 2:s300-4.CrossRefPubMedGoogle Scholar
  17. 17.
    Buess G, Theiss R, Gunther M, Hutterer F, Pichlmaier H. [Transanal endoscopic microsurgery]. Leber Magen Darm. 1985;15:271–279.PubMedGoogle Scholar
  18. 18.
    Cataldo PA. Transanal endoscopic microsurgery. Surg Clin North Am. 2006;86:915–925.CrossRefPubMedGoogle Scholar
  19. 19.
    Langer C, Liersch T, Suss M et al. Surgical cure for early rectal carcinoma and large adenoma: transanal endoscopic microsurgery (using ultrasound or electrosurgery) compared to conventional local and radical resection. Int J Colorectal Dis. 2003;18:222–229.PubMedGoogle Scholar
  20. 20.
    Clancy C, Burke JP, Albert MR, O’Connell PR, Winter DC. Transanal endoscopic microsurgery versus standard transanal excision for the removal of rectal neoplasms: a systematic review and meta-analysis. Dis Colon Rectum. 2015;58:254–261.CrossRefPubMedGoogle Scholar
  21. 21.
    de Graaf EJ, Burger JW, van Ijsseldijk AL, Tetteroo GW, Dawson I, Hop WC. Transanal endoscopic microsurgery is superior to transanal excision of rectal adenomas. Colorectal Dis. 2011;13:762–767.CrossRefPubMedGoogle Scholar
  22. 22.
    Martin-Perez B, Andrade-Ribeiro GD, Hunter L, Atallah S. A systematic review of transanal minimally invasive surgery (TAMIS) from 2010 to 2013. Tech Coloproctol. 2014;18:775–788.CrossRefPubMedGoogle Scholar
  23. 23.
    Atallah S, Albert M, Larach S. Transanal minimally invasive surgery: a giant leap forward. Surg Endosc. 2010;24:2200–2205.CrossRefPubMedGoogle Scholar
  24. 24.
    McLemore EC, Weston LA, Coker AM et al. Transanal minimally invasive surgery for benign and malignant rectal neoplasia. Am J Surg. 2014;208:372–381.CrossRefPubMedGoogle Scholar
  25. 25.
    Lorenz C, Nimmesgern T, Langwieler TE. Transanal Endoscopic Surgery Using Different Single-Port Devices. Surg Technol Int. 2011;XXI:107–111.Google Scholar
  26. 26.
    Ragupathi M, Vande Maele D, Nieto J, Pickron TB, Haas EM. Transanal endoscopic video-assisted (TEVA) excision. Surg Endosc. 2012;26:3528–3535.CrossRefPubMedGoogle Scholar
  27. 27.
    Albert MR, Atallah SB, deBeche-Adams TC, Izfar S, Larach SW. Transanal minimally invasive surgery (TAMIS) for local excision of benign neoplasms and early-stage rectal cancer: efficacy and outcomes in the first 50 patients. Dis Colon Rectum. 2013;56:301–307.CrossRefPubMedGoogle Scholar
  28. 28.
    Morino M, Allaix ME. Transanal endoscopic microsurgery: what indications in 2013? Gastroenterol Rep (Oxf). 2013;1:75–84.CrossRefGoogle Scholar
  29. 29.
    Turler A, Schafer H, Pichlmaier H. Role of transanal endoscopic microsurgery in the palliative treatment of rectal cancer. Scand J Gastroenterol. 1997;32:58–61.CrossRefPubMedGoogle Scholar
  30. 30.
    Ramirez JM, Aguilella V, Gracia JA et al. Local full-thickness excision as first line treatment for sessile rectal adenomas: long-term results. Ann Surg. 2009;249:225–228.CrossRefPubMedGoogle Scholar
  31. 31.
    Mellgren A, Sirivongs P, Rothenberger DA, Madoff RD, Garcia-Aguilar J. Is local excision adequate therapy for early rectal cancer? Dis Colon Rectum. 2000;43:1064–71; discussion 1071–4.CrossRefPubMedGoogle Scholar
  32. 32.
    Kunitake H, Abbas MA. Transanal endoscopic microsurgery for rectal tumors: a review. Perm J. 2012;16:45–50.PubMedCentralCrossRefPubMedGoogle Scholar
  33. 33.
    Atallah S, Martin-Perez B, Albert M et al. Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): results and experience with the first 20 patients undergoing curative-intent rectal cancer surgery at a single institution. Tech Coloproctol. 2014;18:473–480.CrossRefPubMedGoogle Scholar
  34. 34.
    SurgiQuest AirSeal System. Available online at: <http://www.surgiquest.com/what-is-airseal.html>. Last accessed April 2015.
  35. 35.
    Bislenghi G, Wolthuis AM, de Buck van Overstraeten A, D’Hoore A. AirSeal system insufflator to maintain a stable pneumorectum during TAMIS. Tech Coloproctol. 2015;19:43–45.CrossRefPubMedGoogle Scholar
  36. 36.
    Hahnloser D, Cantero R, Salgado G, Dindo D, Rega D, Delrio P. Transanal minimal invasive surgery (TAMIS) for rectal lesions: should the defect be closed? Colorectal Dis. 2014Google Scholar
  37. 37.
    Maglio R, Muzi GM, Massimo MM, Masoni L. Transanal minimally invasive surgery (TAMIS): new treatment for early rectal cancer and large rectal polyps—experience of an Italian center. Am Surg. 2015;81:273–277.PubMedGoogle Scholar
  38. 38.
    Maya A, Vorenberg A, Oviedo M, da Silva G, Wexner SD, Sands D. Learning curve for transanal endoscopic microsurgery: a single-center experience. Surg Endosc. 2014;28:1407–1412.CrossRefPubMedGoogle Scholar
  39. 39.
    Khoo RE. Transanal excision of a rectal adenoma using single-access laparoscopic port. Dis Colon Rectum. 2010;53:1078–1079.CrossRefPubMedGoogle Scholar
  40. 40.
    Gorgun IE, Aytac E, Costedio MM, Erem HH, Valente MA, Stocchi L. Transanal endoscopic surgery using a single access port: a practical tool in the surgeon’s toybox. Surg Endosc. 2014;28:1034–1038.CrossRefPubMedGoogle Scholar
  41. 41.
    Hompes R, Ris F, Cunningham C, Mortensen NJ, Cahill RA. Transanal glove port is a safe and cost-effective alternative for transanal endoscopic microsurgery. Br J Surg. 2012;99:1429–1435.CrossRefPubMedGoogle Scholar
  42. 42.
    Cid RC, Perez JC, Elosua TG et al. [Transanal resection using a single port trocar: a new approach to NOTES]. Cir Esp. 2011;89:20–23.CrossRefPubMedGoogle Scholar
  43. 43.
    Lim SB, Seo SI, Lee JL et al. Feasibility of transanal minimally invasive surgery for mid-rectal lesions. Surg Endosc. 2012;26:3127–3132.CrossRefPubMedGoogle Scholar
  44. 44.
    Cantero R, Salgado G. Transanal access for rectal tumors: the simultaneous use of a flexible endoscope and SILS. Tech Coloproctol. 2014;18:301–302.CrossRefPubMedGoogle Scholar
  45. 45.
    Barendse RM, Doornebosch PG, Bemelman WA, Fockens P, Dekker E, de Graaf EJ. Transanal employment of single access ports is feasible for rectal surgery. Ann Surg. 2012;256:1030–1033.CrossRefPubMedGoogle Scholar
  46. 46.
    Lee TG, Lee SJ. Transanal single-port microsurgery for rectal tumors: minimal invasive surgery under spinal anesthesia. Surg Endosc. 2014;28:271–280.CrossRefPubMedGoogle Scholar
  47. 47.
    van den Boezem PB, Kruyt PM, Stommel MW, Tobon Morales R, Cuesta MA, Sietses C. Transanal single-port surgery for the resection of large polyps. Dig Surg. 2011;28:412–416.CrossRefPubMedGoogle Scholar
  48. 48.
    Atallah SB, Albert MR, deBeche-Adams TH, Larach SW. Robotic transanal minimally invasive surgery in a cadaveric model. Tech Coloproctol. 2011;15:461–464.CrossRefPubMedGoogle Scholar
  49. 49.
    Verheijen PM, Consten EC, Broeders IA. Robotic transanal total mesorectal excision for rectal cancer: experience with a first case. Int J Med Robot. 2014;10:423–426.CrossRefPubMedGoogle Scholar
  50. 50.
    Hompes R, Rauh SM, Ris F, Tuynman JB, Mortensen NJ. Robotic transanal minimally invasive surgery for local excision of rectal neoplasms. Br J Surg. 2014;101:578–581.CrossRefPubMedGoogle Scholar
  51. 51.
    Fernandez-Hevia M, Delgado S, Castells A et al. Transanal total mesorectal excision in rectal cancer: short-term outcomes in comparison with laparoscopic surgery. Ann Surg. 2015;261:221–227.CrossRefPubMedGoogle Scholar
  52. 52.
    Zorron R, Phillips HN, Wynn G, Neto MP, Coelho D, Vassallo RC. “Down-to-Up” transanal NOTES Total mesorectal excision for rectal cancer: preliminary series of 9 patients. J Minim Access Surg. 2014;10:144–150.PubMedCentralCrossRefPubMedGoogle Scholar
  53. 53.
    Chouillard E, Chahine E, Khoury G et al. NOTES total mesorectal excision (TME) for patients with rectal neoplasia: a preliminary experience. Surg Endosc. 2014;28:3150–3157.CrossRefPubMedGoogle Scholar
  54. 54.
    Emhoff IA, Lee GC, Sylla P. Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES). Dig Endosc. 2014;26 Suppl 1:29–42.CrossRefPubMedGoogle Scholar
  55. 55.
    de Lacy AM, Rattner DW, Adelsdorfer C et al. Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection: “down-to-up” total mesorectal excision (TME)—short-term outcomes in the first 20 cases. Surg Endosc. 2013;27:3165–3172.CrossRefPubMedGoogle Scholar
  56. 56.
    Wolthuis AM, Cini C, Penninckx F, D’Hoore A. Transanal single port access to facilitate distal rectal mobilization in laparoscopic rectal sleeve resection with hand-sewn coloanal anastomosis. Tech Coloproctol. 2012;16:161–165.CrossRefPubMedGoogle Scholar
  57. 57.
    Tuech JJ, Bridoux V, Kianifard B et al. Natural orifice total mesorectal excision using transanal port and laparoscopic assistance. Eur J Surg Oncol. 2011;37:334–335.CrossRefPubMedGoogle Scholar
  58. 58.
    Lacy AM, Saavedra-Perez D, Bravo R, Adelsdorfer C, Aceituno M, Balust J. Minilaparoscopy-assisted natural orifice total colectomy: technical report of a minilaparoscopy-assisted transrectal resection. Surg Endosc. 2012;26:2080–2085.CrossRefPubMedGoogle Scholar
  59. 59.
    Lacy AM, Adelsdorfer C, Delgado S, Sylla P, Rattner DW. Minilaparoscopy-assisted transrectal low anterior resection (LAR): a preliminary study. Surg Endosc. 2013;27:339–346.CrossRefPubMedGoogle Scholar
  60. 60.
    Atallah S, Nassif G, Polavarapu H et al. Robotic-assisted transanal surgery for total mesorectal excision (RATS-TME): a description of a novel surgical approach with video demonstration. Tech Coloproctol. 2013;17:441–447.CrossRefPubMedGoogle Scholar
  61. 61.
    Atallah S, Martin-Perez B, Pinan J et al. Robotic transanal total mesorectal excision: a pilot study. Tech Coloproctol. 2014;18:1047–1053.CrossRefPubMedGoogle Scholar
  62. 62.
    Gomez Ruiz M, Palazuelos CM, Martin Parra JI et al. New technique of transanal proctectomy with completely robotic total mesorrectal excision for rectal cancer. Cir Esp. 2014;92:356–361.CrossRefPubMedGoogle Scholar
  63. 63.
    Sylla P. Robotically Assisted Transanal Total Mesorectal Excision: An Exciting New Trend in Rectal Cancer Surgery. Ann Surg. 2015Google Scholar
  64. 64.
    Atallah SB, Albert MR. Transanal minimally invasive surgery (TAMIS) versus transanal endoscopic microsurgery (TEM): is one better than the other? Surg Endosc. 2013;27:4750–4751.CrossRefPubMedGoogle Scholar
  65. 65.
    Rimonda R, Arezzo A, Arolfo S, Salvai A, Morino M. TransAnal Minimally Invasive Surgery (TAMIS) with SILS port versus Transanal Endoscopic Microsurgery (TEM): a comparative experimental study. Surg Endosc. 2013;27:3762–3768.CrossRefPubMedGoogle Scholar
  66. 66.
    Allaix ME, Arezzo A, Giraudo G, Morino M. Transanal endoscopic microsurgery vs. laparoscopic total mesorectal excision for T2N0 rectal cancer. J Gastrointest Surg. 2012;16:2280–2287.CrossRefPubMedGoogle Scholar
  67. 67.
    Nash GM, Weiser MR, Guillem JG et al. Long-term survival after transanal excision of T1 rectal cancer. Dis Colon Rectum. 2009;52:577–582.CrossRefPubMedGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  1. 1.Colorectal Surgical AssociatesHoustonUSA
  2. 2.Division of Minimally Invasive Colorectal Surgery, Department of SurgeryUniversity of Texas Medical School at HoustonHoustonUSA
  3. 3.Division of Colon and Rectal SurgeryHouston Methodist HospitalHoustonUSA

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