Operative and Perioperative Outcomes

Traditionally, rectal neoplasms that were not resectable by colonoscopy required segmental oncologic resection, either via abdominoperineal or low anterior resection. These procedures come with a high risk of operative and postoperative complications that can result in significant patient morbidity as well as significant perioperative costs. Transanal minimally invasive surgery (TAMIS) emerged in 2009, as there was a need for a more widely accessible (easier setup, easier to learn, less expensive) approach to transanal endoscopic excision that was safe and equivalent to transanal endoscopic microsurgery (TEM) for removal of rectal lesions. TAMIS is now a well-established technique for removal of benign lesions and select early rectal cancers (T1) not resectable by endoscopy. This chapter describes the operative and perioperative outcomes associated with TAMIS, emphasizing the technique and complications of this procedure.