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Adegbola et al. Mini-invasive Surg 2018;2:40 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.55

Review Open Access

Transanal minimal invasive surgery - pushing the
boundaries of transanal surgery

Samuel O. Adegbola , Kapil Sahnan , Gianluca Pellino , Janindra Warusavitarne 1,2
1,2
1,2
1,3
1 Department of Surgery, St. Mark’s Hospital, Harrow, Middlesex, HA1 3UJ, UK.
2 Department of Surgery and Cancer, Imperial College, London, SW7 5NH, UK.
3 Department of Medical, Surgical, Neurological, Metabolic, and Ageing Sciences, Università della Campania “Luigi Vanvitelli”,
Naples 80138, Italy.
Correspondence to: Dr. Samuel O. Adegbola, Department of Surgery, St. Mark’s Hospital, Watford Road, Harrow, Middlesex,
HA1 3UJ, UK. E-mail: samadeg@doctors.net.uk
How to cite this article: Adegbola SO, Sahnan K, Pellino G, Warusavitarne J. Transanal minimal invasive surgery - pushing the
boundaries of transanal surgery. Mini-invasive Surg 2018;2:40. http://dx.doi.org/10.20517/2574-1225.2018.55
Received: 31 Jul 2018 First Decision: 30 Oct 2018 Revised: 14 Nov 2018 Accepted: 15 Nov 2018 Published: 28 Nov 2018

Science Editor: Gordon N. Buchanan Copy Editor: Cui Yu Production Editor: Huan-Liang Wu

Abstract
Transanal minimally invasive surgery is a rapidly evolving platform surgery that is facilitating the transanal approach
to colorectal surgery. Over the years since its initial description, the applications have widened and now include
endoluminal and extraluminal approaches to rectal and pelvic surgery. This article discusses the various applications and
future direction of research evaluating this novel technique and its role in colorectal practice.

Keywords: Transanal minimal invasive surgery, rectal surgery

INTRODUCTION
Transanal minimally invasive surgery (TAMIS) describes a platform that evolved from transanal tech-
niques to address mid to low rectal lesions. It represents an alternative to conventional transanal excision
of rectal lesions, transanal endoscopic microsurgery (TEM)/transanal endoscopic operation (TEO) and
[1]
endoscopic submucosal dissection in selected rectal lesions. TAMIS was introduced in 2009 by Atallah et al.
for the purpose of performing endoluminal rectal surgery, and its use has since expanded to include ex-
traluminal approaches, most prominent of which is the transanal total mesorectal excision (taTME) for
rectal cancers. Instead of a purpose-designed proctoscope as is the case with TEM, TAMIS is characterised
by the use of a single-site port transanally in combination with ordinary laparoscopic instruments, a lapa-
roscopic camera lens, and a standard laparoscopic carbon dioxide insufflator. It was developed out of the
need for a practical alternative to TEM that was both affordable and technically feasible without special-

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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