Transanal minimally invasive surgery for rectal cancer

Abstract

Laparoscopic dissection of the lower rectum is a technically demanding procedure in patients with a narrow pelvis and a bulky tumor or in those who are obese. Moreover, transection of the rectum using a stapling device deep in the narrow pelvis is the most difficult part of this operation. Transanal mesorectal dissection using transanal endoscopic microsurgery aims to overcome these limitations and was first reported in 2010. Moreover, following the report by Tuech et al. in 2011, a single-port device with laparoscopic instruments is now widely used as a platform for transanal total mesorectal excision (TME). This convenient approach, referred to as transanal minimally invasive surgery (TAMIS), has been welcomed by surgeons who are used to laparoscopic surgery.