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World J Gastrointest Surg. Oct 27, 2021; 13(10): 1149-1165
Published online Oct 27, 2021. doi: 10.4240/wjgs.v13.i10.1149
Transanal minimally invasive surgery using laparoscopic instruments of the rectum: A review
Myung Jo Kim, Taek-Gu Lee
Myung Jo Kim, Taek-Gu Lee, Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea
Author contributions: Lee TG and Kim MJ reviewed the literature and contributed to manuscript drafting, analysis retrospective studies; Lee TG was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Taek-Gu Lee, MD, Assistant Professor, Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, No. 776, 1 Sunhwan-ro, Seowon-gu, Cheongju 28644, South Korea. ninehouse@hanmail.net
Received: March 7, 2021
Peer-review started: March 7, 2021
First decision: July 15, 2021
Revised: July 18, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: October 27, 2021
Processing time: 233 Days and 0.6 Hours
Abstract

Transanal minimally invasive surgery (TAMIS) was first described in 2010 as an alternative to transanal endoscopic microsurgery (TEM). The TAMIS technique can be access to the proximal and mid-rectum for resection of benign and early-stage malignant rectal lesions and also used for noncurative intent surgery of more advanced lesions in patients who are not candidates for radical surgery. TAMIS has a shorter learning curve, reduced device setup time, flexibility in instrument use, and versatility in application than TEM. Also, TAMIS shows similar results in a view of the operation time, conversion rate, reoperation rate, and complication to TEM. For these reasons, TAMIS is an easily accessible, technically feasible, and cost-effective alternative to TEM. Overall, TAMIS has enabled the performance of high-quality local excision of rectal lesions by many colorectal surgeons. As TAMIS becomes more broadly utilized such as pelvic abscess drainage, rectal stenosis, and treatment of anastomotic dehiscence, the acquisition of appropriate training must be ensured, and the continued assessment and assurance of outcome must be maintained.

Keywords: Transanal minimally invasive; Rectal cancer; Laparoscopic transanal excision; Endoscopic resection; Minimally invasive surgery; Transanal endoscopic microsurgery

Core Tip: Transanal minimally invasive surgery (TAMIS) was introduced in 2010 as a crossover between single-incision laparoscopic surgery and transanal endoscopic microsurgery (TEM). The TAMIS technique can be resected to the proximal and mid-rectal lesion for benign, early-stage cancer, and more advanced lesions in selective patients. TAMIS is an easily accessible, technically feasible, and cost-effective alternative to TEM. TAMIS has proven its usefulness in a wide range of applications outside of local excision, including pelvic abscess drainage, rectal stenosis, and treatment of anastomotic dehiscence. TAMIS like TEM and transanal endoscopic operation with platform difference can achieve the high-quality excision superior to traditional TAE or endoscopic resection, despite the limitations of evidence for large volume or randomized controlled studies.