History and Future of Transanal Minimally Invasive Surgery

  • Elliot G. Arsoniadis
  • Dana SandsEmail author


Transanal minimally invasive surgery first began with the introduction of transanal endoscopic microsurgery (TEM) by Buess and colleagues in 1985. Although mostly restricted to specific centers during the following two decades, advances in laparoscopy, natural orifice transluminal endoscopic surgery (NOTES), and single-incision surgery paved the way for a more accessible platform with the transanal minimally invasive surgery (TAMIS) platform by Atallah and colleagues in 2010. In that same year, Sylla and Lacy described the first transanal total mesorectal excision (TaTME). In the years that followed, hundreds of surgeons would seek out advanced training to learn this exciting technique, and international clinical trials are currently enrolling patients to compare the oncologic and functional outcomes of this technique to established methods of rectal cancer surgery.


Transanal minimally invasive surgery (TAMIS) Transanal total mesorectal excision (TaTME) Transanal endoscopic microsurgery (TEM) Rectal cancer Proctectomy 


  1. 1.
    Buess G, Theiss R, Gunther M, Hutterer F, Pichlmaier H. Endoscopic surgery in the rectum. Endoscopy. 1985;17(1):31–5.CrossRefGoogle Scholar
  2. 2.
    Atallah S. Transanal total mesorectal excision: full steam ahead. Tech Coloproctol. 2015;19(2):57–61.CrossRefGoogle Scholar
  3. 3.
    Maslekar S, Pillinger SH, Sharma A, Taylor A, Monson JRT. Cost analysis of transanal endoscopic microsurgery for rectal tumours. Color Dis. 2007;9(3):229–34.CrossRefGoogle Scholar
  4. 4.
    Atallah S, Albert M, Larach S. Transanal minimally invasive surgery: a giant leap forward. Surg Endosc. 2010;24(9):2200–5.CrossRefGoogle Scholar
  5. 5.
    Remzi FH, Kirat HT, Kaouk JH, Geisler DP. Single-port laparoscopy in colorectal surgery. Color Dis. 2008;10(8):823–6.CrossRefGoogle Scholar
  6. 6.
    Kennedy ML, Lubowski DZ, King DW. Transanal endoscopic microsurgery excision: is anorectal function compromised? Dis Colon Rectum. 2002;45(5):601–4.CrossRefGoogle Scholar
  7. 7.
    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(9):775–88.CrossRefGoogle Scholar
  8. 8.
    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(1):43–5.CrossRefGoogle Scholar
  9. 9.
    Lee L, Kelly J, Nassif GJ, Keller D, Debeche-Adams TC, Mancuso PA, et al. Establishing the learning curve of transanal minimally invasive surgery for local excision of rectal neoplasms. Surg Endosc. 2018;32(3):1368–76.CrossRefGoogle Scholar
  10. 10.
    Bardakcioglu O. Robotic transanal access surgery. Surg Endosc. 2013;27(4):1407–9.CrossRefGoogle Scholar
  11. 11.
    Marks G, Mohiuddin M, Rakinic J. New hope and promise for sphincter preservation in the management of cancer of the rectum. Semin Oncol. 1991;18(4):388–98.PubMedGoogle Scholar
  12. 12.
    Whiteford MH, Denk PM, Swanstrom LL. Feasibility of radical sigmoid colectomy performed as natural orifice transluminal endoscopic surgery (NOTES) using transanal endoscopic microsurgery. Surg Endosc. 2007;21(10):1870–4.CrossRefGoogle Scholar
  13. 13.
    Sylla P, Rattner DW, Delgado S, Lacy AM. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc. 2010;24(5):1205–10.CrossRefGoogle Scholar
  14. 14.
    de Lacy AM, Rattner DW, Adelsdorfer C, Tasende MM, Fernandez M, Delgado S, 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(9):3165–72.CrossRefGoogle Scholar
  15. 15.
    Araujo SE, Crawshaw B, Mendes CR, Delaney CP. Transanal total mesorectal excision: a systematic review of the experimental and clinical evidence. Tech Coloproctol. 2015;19(2):69–82.CrossRefGoogle Scholar
  16. 16.
    Rouanet P, Mourregot A, Azar CC, Carrere S, Gutowski M, Quenet F, et al. Transanal endoscopic proctectomy: an innovative procedure for difficult resection of rectal tumors in men with narrow pelvis. Dis Colon Rectum. 2013;56(4):408–15.CrossRefGoogle Scholar
  17. 17.
    Velthuis S, Nieuwenhuis DH, Ruijter TEG, Cuesta MA, Bonjer HJ, Sietses C. Transanal versus traditional laparoscopic total mesorectal excision for rectal carcinoma. Surg Endosc. 2014;28(12):3494–9.CrossRefGoogle Scholar
  18. 18.
    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.CrossRefGoogle Scholar
  19. 19.
    Atallah SB, DuBose AC, Burke JP, Nassif G, deBeche-Adams T, Frering T, et al. Uptake of transanal total mesorectal excision in North America: initial assessment of a structured training program and the experience of delegate surgeons. Dis Colon Rectum. 2017;60(10):1023–31.CrossRefGoogle Scholar
  20. 20.
    Verheijen PM, Consten ECJ, Broeders IAMJ. Robotic transanal total mesorectal excision for rectal cancer: experience with a first case. Int J Med Robot. 2014;10(4):423–6.CrossRefGoogle Scholar
  21. 21.
    Atallah S, Martin-Perez B, Pinan J, Quinteros F, Schoonyoung H, Albert M, et al. Robotic transanal total mesorectal excision: a pilot study. Tech Coloproctol. 2014;18(11):1047–53.CrossRefGoogle Scholar
  22. 22.
    Atallah S, Nassif G, Larach S. Stereotactic navigation for TAMIS-TME: opening the gateway to frameless, image-guided abdominal and pelvic surgery. Surg Endosc. 2015;29(1):207–11.CrossRefGoogle Scholar
  23. 23.
    Deijen CL, Velthuis S, Tsai A, Mavroveli S, de Lange-de Klerk ESM, Sietses C, et al. COLOR III: a multicentre randomised clinical trial comparing transanal TME versus laparoscopic TME for mid and low rectal cancer. Surg Endosc. 2016;30(8):3210–5.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryCleveland Clinic FloridaWestonUSA

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