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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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