Transanal Minimally Invasive Surgery (TAMIS) resection of early rectal cancer

Francesco Stipa, MD, PhD, FACS, Emanuele Soricelli, MD, Pietro Delle Site, MD, Ettore Santini, MD. Department of Surgery, Colorectal Surgical Unit. San Giovanni Addolorata Hospital – Rome.

 Purpose: Since its introduction in the early 1980s, Transanal Endoscopic Microsurgery (TEM) has become a safe surgical option for large polyps and low risk rectal cancers . Recently single-incision multiport devices have been employed in a wide spectrum of abdominal procedures. In 2010 an innovative technique combining single-port access with the principles of transanal excision, named Transanal Minimally Invasive Surgery (TAMIS), was reported to be a safe and feasible alternative to TEM.

Methods: The video shows the resection of a 3 cm early rectal cancer in a 68 y.o. women with TAMIS approach, using a multichannel port (GelPOINT® Path Transanal Access Platform). As the distal margin of the lesion was very close to the anal verge (< 2 cm), it was dissected transanally with a Park’s retractor before introducing the GelPOINT® device. A full-thickness resection of the lesion was performed with a harmonic scalpel. The side ends of the rectal defect have been repaired with two running absorbable sutures, while the remaining middle portion has been sutured transanally after GelPOINT® removal. Operative time was 60 minutes. No intra- and post-operative complications have been reported. Pathological examination showed a pT1 R0 low well differentiated adenocarcinoma without linfovascular infiltration.

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