Transanal Robotic Surgery and Future Directions

  • Kevin M. Izquierdo
  • Thushy Siva
  • Jean Salem
  • Brigitte Anderson
  • John Marks


Transanal surgery draws its roots from transanal endoscopic microsurgery (TEM), invented by Dr. Gerhard Buess in 1983, and the transanal abdominal transanal proctosigmoidectomy (TATA), as described by Dr. Gerald Marks in 1984. Early experience in TEM focused on excision of benign rectal lesions but was later successfully expanded to the treatment of partial thickness rectal cancer. TATA allowed for the radical excision of distal rectal cancer and addressed the difficulties of operating in the narrow pelvis, obtaining a known distal margin in the radiated rectum and allowing for sphincter preservation with the avoidance of a permanent colostomy. Recent evolution in technology has built upon these techniques and allowed total mesorectal excision to be performed entirely transanally. The challenges of transanal surgery have limited its adoption; however, recent advances in robotic surgery, which include novel platforms such as the Flex® Robotic System, STRAS robot, and da Vinci SP Surgical System, promise to broaden the accessibility of this technique to more surgeons and patients.


Transanal Robotic Rectal cancer taTME TAMIS TEM RTS 



Minimally invasive surgery


Natural orifice transluminal endoscopic surgery


Robotic transanal total mesorectal excision; robotic taTME


Robotic transanal surgery


Single incision laparoscopic surgery


Transanal minimally invasive surgery


Transanal transabdominal proctosigmoidectomy


Transanal total mesorectal excision


Transanal endoscopic microsurgery


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Kevin M. Izquierdo
    • 1
  • Thushy Siva
    • 2
  • Jean Salem
    • 1
  • Brigitte Anderson
    • 3
  • John Marks
    • 3
  1. 1.Lankenau Medical Center, Division of Colorectal SurgeryWynnewoodUSA
  2. 2.Easton Hospital, Department of SurgeryEastonUSA
  3. 3.Colon and Rectal Surgery, Lankenau Medical Center, Marks Colorectal Surgical AssociatesWynnewoodUSA

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