Transanal minimally invasive surgery (TAMIS) with a GelPOINT(r) Path for lower rectal tumor.

Shingo Noura¹, Masayuki Ohue², Norikatsu Miyoshi², Masayoshi Yasui², Tae Matsumura¹, Masaki Hirota¹, Junichi Hasegawa¹. ¹Osaka Rosai Hospital, ²Osaka Medical Center for Cancer and Cardiovascular Diseases

Background: Transanal endoscopic microsurgery (TEM) is a minimally invasive technique. However, TEM has not yet achieved widespread use. Recently, transanal minimally invasive surgery (TAMIS) using single-port surgery devices has been reported.

Methods: We performed TAMIS using a GelPOINT® Path in ten patients with lower rectal tumors. A complete full-thickness excision was performed in all cases. The patient characteristics, operative techniques, and operative outcomes were evaluated.

Results: The mean age of the patients was 61.6 years (range: 48 – 76). The mean operating time and blood loss were 78.9 min (range: 55 – 110) and 4.4 ml (range 0 – 10), respectively. There were no morbidity or mortality. Resection margin was negative in all cases. According to the results of the pathological findings, adjuvant chemotherapy was performed 6 patients. 

Conclusion: TAMIS using a GelPOINT® Path is easy and safe to perform. Although we only treated a small number of cases, we found that the anal function after surgery was favourable and that the operation was sufficiently feasible. TAMIS could play a major role in the resection of large adenomas and early rectal cancers.

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