Single-port robotic transanal minimally invasive surgery (SPR-TAMIS) approach to local excision of rectal tumors. 2021

S Liu, and S R Kelley, and K T Behm
Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Gonda Bldg, Rochester, MN, 55905, USA.

Trans-anal excision is the surgical treatment of choice for endoscopically unresectable rectal polyps, early rectal cancers, small carcinoid tumors, and other low-risk tumors. The single-port robotic (SPR) platform is the newest development in robotic surgery capable of performing trans-anal minimally invasive surgery (TAMIS). In theory, the single incision design would naturally lend itself to the size limitation of the anal canal, but in practice, this method has not been tested. Herein we describe the techniques and first reports of performing TAMIS using the SPR platform. We describe in detail how to perform the SPR-TAMIS technique using lessons and experience gained from performing this on five patients who had endoscopically unresectable rectal polyps or T1 rectal cancers. Each patient was followed for a minimum of 30 days and was seen in clinic post-operatively. A retrospective chart review was performed to obtain information on technical success, anatomic measurements, and reported complications. The SPR TAMIS was successfully performed on all five patients without any reported complications. All underwent a non-piecemeal excision and had return of regular bowel function at 30-day follow-up. All patients were discharged from the hospital the same day as their operation. SPR-TAMIS is a novel, safe, and feasible procedure capable of achieving non-piecemeal resections of low-risk rectal tumors. Further study needs to be conducted to determine complication rates, functional and oncologic outcomes, and ensure the long-term safety profile.

UI MeSH Term Description Entries
D012004 Rectal Neoplasms Tumors or cancer of the RECTUM. Cancer of Rectum,Rectal Cancer,Rectal Tumors,Cancer of the Rectum,Neoplasms, Rectal,Rectum Cancer,Rectum Neoplasms,Cancer, Rectal,Cancer, Rectum,Neoplasm, Rectal,Neoplasm, Rectum,Rectal Cancers,Rectal Neoplasm,Rectal Tumor,Rectum Cancers,Rectum Neoplasm,Tumor, Rectal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000067368 Transanal Endoscopic Surgery Surgical procedures performed through the anus using a PROCTOSCOPE. TAMIS,Transanal Endoscopic Surgical Procedures,Transanal Minimally Invasive Surgery,Endoscopic Surgeries, Transanal,Endoscopic Surgery, Transanal,Surgeries, Transanal Endoscopic,Surgery, Transanal Endoscopic,Transanal Endoscopic Surgeries
D001003 Anal Canal The terminal segment of the LARGE INTESTINE, beginning from the ampulla of the RECTUM and ending at the anus. Anal Gland, Human,Anal Sphincter,Anus,Anal Gland,Anal Glands, Human,Detrusor External Sphincter,External Anal Sphincter,Internal Anal Sphincter,Anal Sphincter, External,Anal Sphincter, Internal,Anal Sphincters,Detrusor External Sphincters,External Anal Sphincters,Human Anal Gland,Human Anal Glands,Internal Anal Sphincters,Sphincter, Anal,Sphincter, Detrusor External,Sphincter, External Anal,Sphincter, Internal Anal,Sphincters, Anal
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D019060 Minimally Invasive Surgical Procedures Procedures that avoid use of open, invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-controlled manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device. Minimal Access Surgical Procedures,Minimal Surgical Procedures,Minimally Invasive Surgical Procedure,Surgical Procedures, Minimally Invasive,Minimal Surgical Procedure,Minimally Invasive Surgery,Procedure, Minimal Surgical,Procedures, Minimal Access Surgical,Procedures, Minimal Surgical,Procedures, Minimally Invasive Surgical,Surgical Procedure, Minimal,Surgical Procedures, Minimal,Surgical Procedures, Minimal Access,Minimally Invasive Surgeries,Surgeries, Minimally Invasive,Surgery, Minimally Invasive
D065287 Robotic Surgical Procedures Surgical procedures performed remotely using a computer that controls surgical instruments attached to mechanical arms designed to perform the tasks of the surgeon. Robot Surgery,Robot-Assisted Surgery,Robot-Enhanced Procedures,Robot-Enhanced Surgery,Robotic-Assisted Surgery,Surgical Procedures, Robotic,Procedure, Robot-Enhanced,Procedure, Robotic Surgical,Procedures, Robotic Surgical,Robot Assisted Surgery,Robot Enhanced Procedures,Robot Enhanced Surgery,Robot Surgeries,Robot-Assisted Surgeries,Robot-Enhanced Procedure,Robot-Enhanced Surgeries,Robotic Assisted Surgery,Robotic Surgical Procedure,Robotic-Assisted Surgeries,Surgery, Robot,Surgery, Robot-Assisted,Surgery, Robot-Enhanced,Surgery, Robotic-Assisted,Surgical Procedure, Robotic

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