Page 11 - Read Online

Jahansouz et al. Mini-invasive Surg 2021;5:1 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.82

Review Open Access

Conventional and robotic transanal minimally
invasive surgery for rectal neoplasia

Cyrus Jahansouz , Elliot G. Arsoniadis , Dana R. Sands 2
1
1
1 Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN 55422, USA.
2 Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
Correspondence to: Dr. Cyrus Jahansouz, Division of Colon and Rectal Surgery, University of Minnesota, 420 Delaware St SE,
Mayo Mail Code 195, Minneapolis, MN 55422, USA. E-mail: jahan023@umn.edu
How to cite this article: Jahansouz C, Arsoniadis EG, Sands DR. Conventional and robotic transanal minimally invasive surgery
for rectal neoplasia. Mini-invasive Surg 2021;5:1. http://dx.doi.org/10.20517/2574-1225.2020.82

Received: 11 Aug 2020 First Decision: 6 Nov 2020 Revised: 6 Dec 2020 Accepted: 15 Dec 2020 Published: 7 Jan 2021

Academic Editor: Sergio W. Larach Copy Editor: Monica Wang Production Editor: Jing Yu

Abstract
The treatment of rectal cancer is evolving at a rapid pace in parallel with advancements in surgical technique. One
such advancement is the application of the laparoscopic platform to the transanal approach, coined transanal
minimally invasive surgery (TAMIS). TAMIS overcomes many of the shortcomings of the traditional transanal
approach to the local resection of rectal neoplasia, offering greater visualization and access to the middle and
upper rectum with improved oncologic outcomes. Following the introduction of conventional TAMIS, the robotic
platform was introduced and applied in analogous fashion. Over the past decade, data have accumulated enabling
the comparison of the two approaches most notably with regard to patient morbidity, mortality, and oncologic
outcomes. This review discusses the most recently available outcomes regarding conventional and robotic TAMIS
and provides a comparison of the two platforms in the treatment of rectal neoplasia. While randomized controlled
trials comparing the two platforms are lacking, important differences have been identified. Conventional TAMIS is
the more cost-effective approach while advancements in the robotic platform allow the surgeon to be seated and
ergonomically optimized, allowing greater visualization and ease of suturing. Differences in oncologic outcomes
between the two platforms have not been identified. Head-to-head randomized controlled trials are required to
determine if any differences in functional or oncologic outcomes exist.

Keywords: Rectal cancer, transanal minimally invasive surgery(TAMIS), laparoscopy, robotic surgery

© The Author(s) 2021. 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.

www.misjournal.net