TAMIS: New Horizons in Modern Colorectal Surgery

Abstract

Transanal minimally invasive surgery (TAMIS) has emerged as a major advancement in the management of rectal neoplasms. Building upon the principles of transanal endoscopic microsurgery (TEM), TAMIS provides a cost-effective and more accessible alternative that integrates standard laparoscopic instruments. To present a comprehensive review of the development, indications, technique, and clinical outcomes associated with TAMIS and to evaluate its current role and future potential in modern colorectal surgery. This narrative review was conducted through a comprehensive analysis of the literature on TAMIS, TEM, and transanal endoscopic surgery, focusing on the evolution of the technique, patient selection, operative strategy, oncological safety, and recent technological advancements such as robotic platforms. TAMIS is effective in the excision of benign rectal neoplasms and carefully selected early-stage rectal cancers, offering high R0 resection rates and low recurrence. It is less invasive than conventional surgery, preserves rectal function, and is associated with reduced morbidity. Although it requires a moderate learning curve, its technical feasibility and low setup cost have contributed to its widespread adoption. Comparative studies support its oncological adequacy, particularly in selected T1 cancers and ypT0 tumors following neoadjuvant therapy. TAMIS represents a transformative innovation in colorectal surgery. As technology and surgical expertise continue to evolve, TAMIS is expected to become integrated into standard oncological practice, expanding its indications and improving functional outcomes. Continued research and long-term follow-up are necessary to further define its role in the treatment of rectal cancer.

Keywords

• transanal minimally invasive surgery
• transanal endoscopic microsurgery
• rectal cancer
• transanal surgery
• local excision
• minimally invasive surgery
• colorectal surgery