Transanal Minimally Invasive Surgery (TAMIS) for Local Excision of Benign and Malignant Rectal Neoplasia - A 7-Year Experience

Sep 21, 2026

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Transanal minimally invasive surgery (TAMIS) is used to perform high-quality local excision of rectal neoplasia via an advanced transanal platform. This single-unit 7-year experience reports clinical and midterm oncological outcomes for consecutive patients treated between 2016 and 2022. Indications included benign lesions unsuitable for endoscopic excision and histologically favorable early rectal cancers. Primary outcomes were resection quality, disease recurrence, and peri-operative results using Kaplan–Meier analyses for disease-free survival.

LanguageEnglish

CategoryHealthcare

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Pages8

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Langenbeck's Archives of Surgery (2024) 409:32 [https://doi.org/10.1007/s00423-023-03217-4](https://doi.org/10.1007/s00423-023-03217-4) Transanal minimally invasive surgery (TAMIS) for local excision of benign and malignant rectal neoplasia: a 7‑year experience William P. Duggan1,2 · Niall Heagney1 · Sean Gray1 · Enda Hannan1 · John P. Burke1 Received: 2 August 2023 / Accepted: 29 December 2023 © The Author(s) 2024 Abstract Purpose Transanal minimally invasive surgery (TAMIS) is an advanced transanal platform that can be utilised to perform high-quality local excision (LE) of rectal neoplasia. This study describes clinical and midterm oncological outcomes from a single unit’s 7-year experience with TAMIS. Methods Consecutive patients who underwent TAMIS LE at our institution between January 1st, 2016, and December 31st, 2022, were identified from a prospectively maintained database. Indication for TAMIS LE was benign lesions not amenable to endoscopic excision or histologically favourable early rectal cancers. The primary endpoints were resection quality, disease recurrence and peri-operative outcomes. The Kaplan–Meier survival analyses were used to describe disease-free survival (DFS) for patients with rectal adenocarcinoma that did not receive immediate salvage proctectomy. Results There were 168 elective TAMIS LE procedures performed for 102 benign and 66 malignant lesions. Overall, a 95.2% negative margin rate was observed, and 96.4% of lesions were submitted without fragmentation. Post-operative morbidity was recorded in 8.3% of patients, with post-operative haemorrhage, being the most common complication encountered. The mean follow-up was 17 months (SD 15) . Local recurrence occurred in 1.6%, and distant organ metastasis was noted in 1.6% of patients. Conclusions For carefully selected patients, TAMIS for local excision of early rectal neoplasia is a valid option with low morbidity that maintains the advantages of organ preservation. Keywords TAMIS · Minimally invasive surgery · Rectal cancer · Surgical oncology Introduction Proctectomy with total mesorectal excision (TME) remains the standard of care for management of rectal cancer [1, 2] . Despite providing effective local tumour control, proctectomy with TME is associated with a significant risk of peri-operative morbidity, and a 3% risk of mortality [3] . From a quality of life (QOL) perspective, a significant proportion of patients will also require a temporary or permanent stoma, and for patients who undergo a low anterior resection, the incidence of low anterior resection syndrome is up to 45%[4, 5] . * John P. Burke [johnburke@rcsi.ie](johnburke@rcsi.ie) 1 Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland 2 Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland The widespread implementation of national screening programmes has led to a significant increase in rates of detection of early rectal neoplasms [6, 7]. This, coupled with advances in the scope and efficacy of modern neoadjuvant therapies, has resulted in a significant increase in the proportion of rectal cancers potentially amenable to local excision [8] . Consequently, there has been a growing trend towards implementation of less invasive procedures and rectum-preserving techniques. There are two predominant rectum sparing approaches to transanal excision: transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS) . Gerhard Buess first described TEM in 1984. It involves the use of a set of highly specialised instruments applied through a fixed metallic platform placed in the anal canal [9] . Atallah et al. first described transanal minimally invasive surgery (TAMIS) in 2010 [10] . TAMIS allows the use of standard laparoscopic cameras and instruments used in collaboration with a single-use flexible transanal access platform [11] . Some benefits of TAMIS over TEM include a lowe

FAQs

What is TAMIS and what is it used for in this study?

TAMIS is a transanal minimally invasive platform used to perform local excision of rectal neoplasia. This study evaluates clinical and midterm oncological outcomes from a single unit’s 7-year experience.

Who were the patients selected for TAMIS local excision?

Patients underwent TAMIS local excision for benign lesions not amenable to endoscopic excision and histologically favorable early rectal cancers. Indications also included low-grade neuroendocrine tumours and stage I rectal adenocarcinomas with favorable histology.

What were the key resection and oncological outcomes?

Among 168 elective TAMIS procedures, the negative margin rate was 95.2% and 96.4% of lesions were submitted without fragmentation. Local recurrence was 1.6%, and distant organ metastasis was noted in 1.6% of patients.

Sep 21, 2026

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