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Feasibility of transanal minimally invasive surgery for mid-rectal lesions
Surgical Endoscopy, 05/09/2012
Lim SB et al. – Transanal minimally invasive surgery (TAMIS) seems to be a feasible and safe treatment option for lesions located in the mid rectum.
Methods- From July 2010 to October 2011, 16 consecutive patients with rectal pathology underwent TAMIS.
- After a single–incision laparoscopic surgery port was introduced into the anal canal, pneumorectum was established with a laparoscopic device, followed by transanal excision with conventional laparoscopic instruments, including graspers, monopolar electrocautery, and needle drivers.
- Clinicopathological findings, surgical procedure results, and perioperative outcomes were determined prospectively.
- Of the 16 patients, 11 had rectal cancers (3 T1 lesions and 8 after preoperative chemoradiotherapy), 4 had neuroendocrine tumors, and 1 had a mucocele.
- The median length of the lesions from anal verge was 7.5 cm (range 4–10 cm).
- All procedures were completed laparoscopically without conversion to conventional transanal approach.
- The median operating time was 86 min (range 33–160 min), and the median estimated blood loss was 15 ml (range 0–150 ml) with no patient requiring intraoperative transfusions.
- There was no surgical morbidity or mortality, but one patient died during follow–up due to synchronous advanced gastric cancer.
- The median postoperative hospital stay was 3 days (range 2–6 days).
