Christine Tat, MD, Joaquin Estrada, MD, Jan P Kaminski, MD, MBA. Advocate Illinois Masonic Medical Center
Transanal minimally invasive surgery (TAMIS) is an advanced laparoscopic procedure used to excise rectal lesions via the anus. TAMIS is an accessible procedure to general surgeons in the community as it utilizes standard laparoscopic instruments without additional specialized equipment.
Patients can benefit from incision-less surgery via TAMIS to remove benign polyps, carcinoids, tumors in situ, and T1 tumors with low risk histopathological features. A preoperative work-up includes a digital rectal exam, proctoscopy, pelvic MRI, endorectal ultrasound, CEA, and CT of chest, abdomen, and pelvis in order to fully evaluate the lesion.
Our patient was a 71 year old female with a large rectal mass found on colonoscopy. A polypectomy was attempted unsuccessfully, however, the biopsy revealed a villous adenoma and pre-operative work-up was negative for regional or distant metastases.
TAMIS procedure was performed successfully with key technical points highlighted. Final pathology was consistent with a villous adenoma with high grade dysplasia and negative margins.
In summary, TAMIS is a novel technique for excision of rectal lesions that can avoid major abdominal surgery for patients. The procedure utilizes standard laparoscopic instruments and is adaptable for general surgeons with laparoscopic skills.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86554
Program Number: V255
Presentation Session: Friday Video Loop (Non CME)
Presentation Type: VideoLoop
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