Local management of middle and upper third rectal lesions has always been a challenge for both benign and early stage malignant tumors due to their difficult access.

In 1983, Buess developed transanal endorectal microsurgery (TEM [transanal endorectal microsurgery]) as an alternative to local excision of mid and upper rectal lesions via the transanal route. Thanks to its platform, the TEM provides a better three-dimensional view with a wider range of the operative field, maintains rectal distension with CO₂The platform, which is limited by the height of the polyp and the extent of the lesions, as well as the time required to install the platform and the high cost of the materials, achieves a higher quality resection and a better closure of the resection defect. As biomedical technology has advanced, surgeons’ knowledge of minimally invasive surgery has also increased, combining both and using the same instrument for various applications, such as the use of endoscopes in natural orifice surgery (NOTES) or the use of a transanal laparoscopy port (TAMIS).

Thus was born the TAMIS (transanal minimally invasive surgery) technique, described in 2009 with collaborators such as Dr. Matthew Albery and Dr. Sam Atallah.

Transanal minimally invasive surgery (TAMIS) is a minimally invasive procedure as its name implies, for resection of benign tumors (polyps) in the rectum, which for some reason cannot be removed by colonoscopy, either by a very wide base, or places where there is a possibility of major bleeding when performing endoscopic polypectomy or perforation. It is also a procedure for resection of early stage rectal cancer.

TAMIS has proven to be a feasible alternative to TEM for resection of both benign and malignant lesions of the rectum in early stages, with the same benefits as TEM, with a shorter preparation time, cheaper instrumentation with an adaptation of laparoscopic instruments and at a much lower cost. We must always perform staging in malignant tumors, to provide the appropriate procedure to the patient.

Dr. Robert E. Liriano Stambuly, M.D.
Colorectal Surgeon