Log in

Transanal Minimally Invasive Surgery in the Treatment of Large Polyps and Early Rectal Carcinoma

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Transanal minimally invasive surgery is a relatively new diagnostic and therapeutic approach for removing pathological lesions localized in the mid-rectum and its distal third. The availability of laparoscopic equipment and its low cost made this procedure dominant over others. A total of 12 patients underwent afore-mentioned procedure at the Clinical Hospital Center of Zemun. Patients were diagnosed with either benign adenomas or early rectal carcinoma, all verified by histopathological analysis, which could not be removed using endoscopic methods. During the research, we examined the procedure’s feasibility, the margin’s negativity, length of hospital stays, and early complications. The average distance of lesions from the anocutaneous line was 8.1 cm. Mucosectomy was most often performed, followed by full-thickness resection of the rectal wall and resection of the rectal wall with part of the mesorectal tissue. The average size of polypoid lesions was 3 cm. We had positive margins in only one case. The postoperative hospital stay was average 1.8 days. Regarding early postoperative complications, we had one case of postoperative bleeding, which was treated with endoscopic hemostasis. All transanal resection techniques aim to obtain adequate, negative margins of resected pathological lesion. A high percentage of patients with negative margins and a low level of postoperative complications make this procedure applicable in modern practice. This procedure has proven to be a safe, effective and reproducible technique. With the development of the surgical technique, it will be increasingly used to perform more complex colorectal operations in our center.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Atallah S, Albert M, Larach S (2010) Transanal minimally invasive surgery: a giant leap forward. Surg Endosc 24(9):2200–2205. https://doi.org/10.1007/S00464-010-0927-Z

    Article  PubMed  Google Scholar 

  2. Buess G, Theiss R, Gunther M, Hutterer F, Pichlmaier H (1985) Endoscopic surgery in the rectum. Endoscopy 17(1):31–35. https://doi.org/10.1055/S-2007-1018451

    Article  CAS  PubMed  Google Scholar 

  3. Kim MJ, Lee T-G (2021) Transanal minimally invasive surgery using laparoscopic instruments of the rectum: A review. World J Gastrointest Surg 13(10):1149. https://doi.org/10.4240/WJGS.V13.I10.1149

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Shen JM, Zhao JY, Ye T, Gong LF, Wang HP, Chen WJ et al (2020) Transanal minimally invasive surgery vs endoscopic mucosal resection for rectal benign tumors and rectal carcinoids: a retrospective analysis. World J Clin Cases 8(19):4311. https://doi.org/10.12998/WJCC.V8.I19.4311

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bislenghi G, Wolthuis AM, De Buck van Overstraeten A, D’Hoore A (2015) AirSeal system insufflator to maintain a stable pneumorectum during TAMIS. Tech Coloproctol 19(1):43–5. https://doi.org/10.1007/S10151-014-1244-7

    Article  CAS  PubMed  Google Scholar 

  6. Pangeni A, Imtiaz MR, Rai S, Shrestha AK, Basnyat P (2023) Transanal minimally invasive surgery - a single-center experience. J Minim Access Surg 19(1):35–41. https://doi.org/10.4103/JMAS.JMAS_390_21

    Article  PubMed  PubMed Central  Google Scholar 

  7. Dekkers N, Boonstra JJ, Moons LMG, Hompes R, Bastiaansen BA, Tuynman JB, et al. Transanal minimally invasive surgery (TAMIS) versus endoscopic submucosal dissection (ESD) for resection of non-pedunculated rectal lesions (TRIASSIC study): study protocol of a European multicenter randomised controlled trial. BMC Gastroenterol. 2020;20(1). https://doi.org/10.1186/S12876-020-01367-Z

  8. Dufresne AM, Withers R, Ramkumar J, Mackenzie S, Melich G, Vikis E (2018) Trans-anal minimally invasive surgery: a new technique to avoid peritoneal entry. Int J Surg Case Rep 52:11. https://doi.org/10.1016/J.IJSCR.2018.09.029

    Article  PubMed  PubMed Central  Google Scholar 

  9. Caycedo-Marulanda A, Jiang HY, Kohtakangas EL (2017) Transanal minimally invasive surgery for benign large rectal polyps and early malignant rectal cancers: experience and outcomes from the first Canadian centre to adopt the technique. Can J Surg 60(6):416–423. https://doi.org/10.1503/CJS.002417

    Article  PubMed  PubMed Central  Google Scholar 

  10. Martin-Perez B, Andrade-Ribeiro GD, Hunter L, Atallah S (2014) A systematic review of transanal minimally invasive surgery (TAMIS) from 2010 to 2013. Tech Coloproctol 18(9):775–788. https://doi.org/10.1007/S10151-014-1148-6

    Article  CAS  PubMed  Google Scholar 

  11. Mehraj A, Saqib N, Wani R, Chowdri N, Parray F, Khan M (2021) Transanal minimal invasive surgery (TAMIS): safety and feasibility for the resection of benign and malignant lesions of the rectum. Turk J Surg. 37(1):6. https://doi.org/10.47717/TURKJSURG.2021.5057

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lee L, Burke JP, Debeche-Adams T, Nassif G, Martin-Perez B, Monson JRT et al (2018) Transanal minimally invasive surgery for local excision of benign and malignant rectal neoplasia: outcomes from 200 consecutive cases with midterm follow up. Ann Surg 267(5):910–916. https://doi.org/10.1097/SLA.0000000000002190

    Article  PubMed  Google Scholar 

  13. Mohamed B, Aung M, Mohammed A, Mohamed M, Edilbe M. Initial experience with trans-anal minimally invasive surgery (TAMIS) for rectal polyps and early colorectal cancers at cumberland infirmary, Carlisle. Cureus. 2022;14(11). https://doi.org/10.7759/CUREUS.31958

  14. Abutaka A, Ahmed A, Abunada M, Kurer M. Transanal minimally invasive surgery (TAMIS) in Qatar: initial experience. BMC Surg. 2020;20(1). https://doi.org/10.1186/S12893-020-00797-6

  15. Cozzi MR, Lauretta A, Vettori R, Steffan A. Acquired factor XII deficiency following transanal excision of rectal lesion by transanal minimally invasive surgery (TAMIS): a case report and literature review. World J Surg Oncol. 2018;16(1). https://doi.org/10.1186/S12957-018-1410-X

  16. Chen N, Peng YF, Yao YF, Gu J (2018) Trans-anal minimally invasive surgery for rectal neoplasia: Experience from single tertiary institution in China. World J Gastrointest Oncol 10(6):137. https://doi.org/10.4251/WJGO.V10.I6.137

    Article  PubMed  PubMed Central  Google Scholar 

  17. Haugvik SP, Groven S, Bondi J, Vågan T, Brynhildsvoll SO, Olsen OC (2016) A critical appraisal of transanal minimally invasive surgery (TAMIS) in the treatment of rectal adenoma: a 4-year experience with 51 cases. Scand J Gastroenterol 51(7):855–859. https://doi.org/10.3109/00365521.2016.1157891

    Article  PubMed  Google Scholar 

  18. Hahnloser D, Cantero R, Salgado G, Dindo D, Rega D, Delrio P (2015) Transanal minimal invasive surgery for rectal lesions: should the defect be closed? Colorectal Dis 17(5):397–402. https://doi.org/10.1111/CODI.12866

    Article  CAS  PubMed  Google Scholar 

  19. Sevá-Pereira G, Trombeta VL, Capochim Romagnolo LG (2014) Transanal minimally invasive surgery (TAMIS) using a new disposable device: our initial experience. Tech Coloproctol 18(4):393–397. https://doi.org/10.1007/S10151-013-1036-5

    Article  PubMed  Google Scholar 

  20. Zammit AP, Lyons NJ, Chatfield MD, Hooper JD, Brown I, Clark DA et al (2022) Patient and pathological predictors of management strategy for malignant polyps following polypectomy: a systematic review and meta-analysis. Int J Colorectal Dis 37(5):1035–1047. https://doi.org/10.1007/S00384-022-04142-6

    Article  PubMed  PubMed Central  Google Scholar 

  21. Leong FQH, Chong CS (2019) Transanal minimally invasive surgery (TAMIS) for large rectal polyps. Ann Surg Oncol 26(5):1428. https://doi.org/10.1245/S10434-019-07171-8/METRICS

    Article  PubMed  Google Scholar 

  22. Parker J, Gupta S, Shenbagaraj L, Harborne P, Ramaraj R, Karandikar S et al (2023) Outcomes of complex colorectal polyps managed by multi-disciplinary team strategies—a multi-centre observational study. Int J Colorectal Dis 38(1):28. https://doi.org/10.1007/S00384-022-04299-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Medina-Prado L, Mangas-Sanjuan C, Baile-Maxía S, Martínez-Roca AA, Murcia Ó, Zarraquiños S et al (2022) Risk of colorectal cancer and advanced polyps one year after excision of high-risk adenomas. Dis Colon Rectum 65(9):1112–1120. https://doi.org/10.1097/DCR.0000000000002068

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dejan Stevanović.

Ethics declarations

Ethical Approval

We confirm that we have read the journal’s position on issues involving ethical publication and affirm that this work is consistent with those guidelines. This work was approved by the institutional ethics committee, and written consent was obtained from the patients for the publication of the report and any accompanying images.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stevanović, D., Mitrović, N., Jašarović, D. et al. Transanal Minimally Invasive Surgery in the Treatment of Large Polyps and Early Rectal Carcinoma. Indian J Surg (2024). https://doi.org/10.1007/s12262-024-04039-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12262-024-04039-4

Keywords

Navigation