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Transanal Minimally Invasive Surgery

 

What is Transanal Minimally Invasive Surgery?

TAMIS stands for Transanal Minimally Invasive Surgery. This is a surgical technique used primarily for the removal of rectal tumors – either advanced rectal polyps or early-stage rectal cancer. In TAMIS, surgeons use specialized instruments inserted through the anus to access and remove tumors located in the rectum. It's considered a minimally invasive approach because it avoids the need for large abdominal incisions, resulting in potentially faster recovery times and reduced risk of complications compared to traditional open surgery. TAMIS is often utilized for small to medium-sized rectal tumors that are not amenable to endoscopic removal but are still suitable for a minimally invasive approach.

Benefits of TAMIS

TAMIS offers several benefits:

  • Preservation of Rectal Function: For benign polyps and some early-stage Rectal Cancer tumors, TAMIS can provide the opportunity for a specially-trained Colorectal Surgery to remove the tumor while preserving the rectum. This approach provides significant benefit for bowel function and stooling habits following surgery.
  • Preservation of Anal Function: Since TAMIS accesses the rectum through the anus, it often allows surgeons to preserve anal function better than traditional surgical approaches, which may require larger incisions and more extensive tissue removal.
  • Precision and Visualization: TAMIS provides surgeons with a high-definition, magnified view of the rectal area, allowing for precise tumor removal while minimizing damage to surrounding healthy tissue. This enhanced visualization can lead to better outcomes and reduced risk of recurrence.
  • Shorter Hospital Stay: For many patients, TAMIS can be performed as an outpatient procedure. For others, an overnight observation stay may be warranted. TAMIS provides the opportunity for significantly shorter hospital stays compared to those undergoing traditional open surgery leading to quicker recovery and a faster return to normal activities.
  • Lower Risk of Complications: With its minimally invasive nature and precise approach, TAMIS is associated with a lower risk of complications such as wound infections, bleeding, and postoperative ileus (intestinal blockage).

Overall, TAMIS represents a significant advancement in the treatment of rectal polyps and early-stage rectal tumors, offering patients a safer, less invasive option with favorable outcomes.

Risk Factors of TAMIS

While TAMIS (Transanal Minimally Invasive Surgery) is generally considered safe, like any surgical procedure, it carries certain risks. These risks may include:

  • Bleeding: There is a risk of bleeding during or after TAMIS, which can vary in severity. In most cases, any bleeding can be controlled by the surgical team during the procedure or managed postoperatively.
  • Infection: As with any surgical procedure, there is a risk of infection at the surgical site or within the abdomen. This risk is typically minimized through careful sterile technique during the procedure and the use of preventative antibiotics before surgery.
  • Damage to Surrounding Structures: During TAMIS, there is a possibility of unintentional damage to nearby structures such as the rectum, anus, or nearby blood vessels. Surgeons take precautions to minimize this risk, but it can still occur in rare cases.
  • Anesthesia Risks: TAMIS requires anesthesia, which carries its own set of risks, including allergic reactions, respiratory problems, heart problems, and adverse reactions to anesthesia medications. These risks are typically minimized through careful preoperative evaluation and monitoring during the procedure.
  • Bowel Dysfunction: Following TAMIS, some patients may experience temporary or permanent changes in bowel function, such as increased frequency of bowel movements, urgency, or incontinence. These changes are usually temporary but can sometimes persist.
  • Urinary Dysfunction: In some cases, TAMIS may lead to urinary dysfunction, such as difficulty urinating or urinary incontinence. This is typically temporary.
  • Recurrence of Tumor: Despite successful tumor removal during TAMIS, there is always a risk of tumor recurrence. Recurrence may occur at the site of resection or within the surrounding lymph nodes. A careful surveillance plan following surgery will help to provide early detection and treatment of recurrence.

It's important to discuss these risks with your surgeon before undergoing TAMIS and to carefully follow their preoperative and postoperative instructions to minimize the likelihood of complications. Additionally, the specific risks associated with TAMIS can vary depending on factors such as the size and location of the tumor, your overall health, and any preexisting medical conditions.

What to Expect During TAMIS

TAMIS is a highly specialized technique with significant benefit in advanced polyps and early-stage rectal tumors. Your colorectal surgeon may inform you that they plan to enlist the help and assistance of one of their surgical partners in this procedure. Within the surgery department at The Iowa Clinic, close collaboration and teamwork between surgeons provides benefit to each patient and increases expertise available for each procedure.