Abstract
Despite development of the transanal endoscopic microsurgery (TEM) system for 30 years, it is being used only by a handful of surgeons. High initial cost, complex instrumentation, steep learning curve, and the necessity for specialized training remain significant obstacles for wider adoption. Transanal minimally invasive surgery (TAMIS) on the other hand is rapidly gaining popularity owing to its low cost, simple setup, and the use of traditional laparoscopic equipment. TAMIS is a versatile platform, which offers several applications beyond local excision. One of the most important applications for TAMIS beyond local excision is to be able to perform a total mesorectal excision transanally called TAMIS-TME. This is a promising new approach to facilitate distal rectal mobilization and thus represents a new era in rectal cancer surgery. The TAMIS platform has also been used in conjunction with a robotic platform to perform local excision of rectal neoplasms as well as radical proctectomy for rectal cancer. This chapter will review the technique of TAMIS and differences to the TEM platform described in the previous chapter.
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