Advertisement

Transanal Minimally Invasive Surgery (TAMIS)

  • Sergio W. LarachEmail author
  • Harsha V. Polavarapu
Chapter
  • 1.4k Downloads

Abstract

Despite development of the transanal endoscopic microsurgery (TEM) system for 30 years, it is being used only by a handful of surgeons. High initial cost, complex instrumentation, steep learning curve, and the necessity for specialized training remain significant obstacles for wider adoption. Transanal minimally invasive surgery (TAMIS) on the other hand is rapidly gaining popularity owing to its low cost, simple setup, and the use of traditional laparoscopic equipment. TAMIS is a versatile platform, which offers several applications beyond local excision. One of the most important applications for TAMIS beyond local excision is to be able to perform a total mesorectal excision transanally called TAMIS-TME. This is a promising new approach to facilitate distal rectal mobilization and thus represents a new era in rectal cancer surgery. The TAMIS platform has also been used in conjunction with a robotic platform to perform local excision of rectal neoplasms as well as radical proctectomy for rectal cancer. This chapter will review the technique of TAMIS and differences to the TEM platform described in the previous chapter.

Keywords

Transanal Minimally Invasive Surgery (TAMIS) Rectal cancer Colorectal surgery Total mesorectal excision 

Supplementary material

Video 27.1

Port insertion (WMV 4 kb)

Video 27.2

Lesion marking (WMV 4 kb)

Video 27.3

Submucosal dissection (WMV 4 kb)

Video 27.4

Full-thickness dissection (WMV 4 kb)

Video 27.5

Closure suture (WMV 4 kb)

Video 27.6

Closure Endo Stitch™ (Covidien) (WMV 4 kb)

Video 27.7

Closure Running Device RD180™ (LSI Solutions) (WMV 4 kb)

References

  1. 1.
    Corman ML. Classic articles in colonic and rectal surgery (Jacques Lisfranc 1790–1847. Observation on a cancerous condition of the rectum treated by excision). Dis Colon Rectum. 1983;26:694–5.CrossRefGoogle Scholar
  2. 2.
    Arnaud A, Fretes IR, Joly A, et al. Posterior approach to the rectum for treatment of selected benign lesions. Int J Colorectal Dis. 1991;6:100–2.CrossRefPubMedGoogle Scholar
  3. 3.
    Miles EW. A method of performing abdominoperineal excision for carcinoma of the rectum and of the terminal portion of the pelvic column. Lancet. 1908;2:1812–3.CrossRefGoogle Scholar
  4. 4.
    Buess G, et al. A system for a transanal endoscopic rectum operation. Chirurg. 1984;55(10):677–80.PubMedGoogle Scholar
  5. 5.
    Atallah S, Albert M, Larach S. Transanal minimally invasive surgery: a giant leap forward. Surg Endosc. 2010;24:2200–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Cataldo PA. Transanal endoscopic microsurgery. Surg Clin North Am. 2006;86:915–25.CrossRefPubMedGoogle Scholar
  7. 7.
    Maslekar S, Pillinger SH, Sharma A, et al. Cost analysis of transanal endoscopic microsurgery for rectal tumours. Colorectal Dis. 2007;9:229–34.CrossRefPubMedGoogle Scholar
  8. 8.
    Koebrugge B, Bosscha K, Ernst MF. Transanal endoscopic microsurgery for local excision of rectal lesions: is there a learning curve? Dig Surg. 2009;26:372–7.CrossRefPubMedGoogle Scholar
  9. 9.
    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(3):301–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Atallah S, Albert M, Debeche-Adams T, Larach S. Transanal minimally invasive surgery (TAMIS): applications beyond local excision. Tech Coloproctol. 2012;17:239–43.CrossRefPubMedGoogle Scholar
  11. 11.
    Atallah S, Albert M, DeBeche-Adams T, Nassif G, Polavarapu H, Larach S. Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): a stepwise description of the surgical technique with video demonstration. Tech Coloproctol. 2013;17(3):321–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Atallah S, Martin-Perez B, Albert M, Debeche-Adams T, Nassif G, Hunter L, Larach S. 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. 2013;18:473–80. [Epub ahead of print].CrossRefPubMedGoogle Scholar
  13. 13.
    Atallah SB, Albert MR, deBeche-Adams TH, Larach SW. Robotic transanal minimally invasive surgery in a cadaveric model. Tech Coloproctol. 2011;15:461–4.CrossRefPubMedGoogle Scholar
  14. 14.
    Atallah S, Parra-Davilla E, DeBeche-Adams T, Albert M, Larach S. Excision of a rectal neoplasm using robotic transanal surgery (RTS): a description of the technique. Tech Coloproctol. 2012;16:389–92.CrossRefPubMedGoogle Scholar
  15. 15.
    Bardakcioglu O. Robotic transanal access surgery. Surg Endosc. 2013;27(4):1407.CrossRefPubMedGoogle Scholar
  16. 16.
    Atallah S, Nassif G, Polavarapu H, deBeche-Adams T, Ouyang J, Albert M, Larach S. Robotic-assisted transanal surgery for total mesorectal excision (RATS-TME): a description of a novel surgical approach with video demonstration. Tech Coloproctol. 2013;17(4):441–7.CrossRefPubMedGoogle Scholar
  17. 17.
    Hayashi M, Asakuma M, Komeda K, Miyamoto Y, Hirokawa F, Tanigawa N. Effectiveness of a surgical glove port for single port surgery. World J Surg. 2010;34:2487–9.CrossRefPubMedGoogle Scholar
  18. 18.
    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(10):1429–35.CrossRefPubMedGoogle Scholar
  19. 19.
    Lezoche E, Guerrieri M, Paganini AM, et al. Long-term results in patients with T2-3 N0 distal rectal cancer undergoing radiotherapy before transanal endoscopic microsurgery. Br J Surg. 2005;92:1546–52.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Colon and Rectal SurgeryFlorida HospitalOrlandoUSA

Personalised recommendations