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<p>Transanal minimally invasive surgery (TAMIS) is a widely used technique for treating rectal neoplasms,&#xa0;traditionally performed using a well-established laparoscopic platform. Recently, robotic TAMIS (R-TAMIS)&#xa0;has gained popularity due to potential advantages in ergonomics, visualization, and instrument dexterity. This study was designed to review the experience of a colorectal surgery group with both robotic and laparoscopic TAMIS (L-TAMIS)&#xa0;and to compare their short-term surgical outcomes. A retrospective chart review was conducted of the last 53 consecutive patients who underwent laparoscopic or robotic TAMIS for rectal neoplasms by four colorectal surgeons from October 2014 to September 2025. We collected data on patient demographics, surgical variables, pathological outcomes,&#xa0; and 30-day complications. Demographic variables were similar between groups. A significantly larger median lesion size was observed in the R-TAMIS group (3.63 cm vs. 2.49 cm; <i>p</i> = 0.001). The average lesion distance from the anal verge was comparable, 8.08 cm (3–13 cm) for R-TAMIS and 7.52 cm (3–15 cm) for L-TAMIS. The mean operative time was 78 (±26.81) minutes for R-TAMIS and 71 (±25.49) minutes for L-TAMIS. No conversions or 30-day mortalities occurred in either group. After the introduction of R-TAMIS in 2022, operative times remained largely stable over time, with only a slight downward trend and no clear learning-curve effect. There was an approximately USD 757 increase in cost for R-TAMIS compared with L-TAMIS. R-TAMIS was associated with resection of larger lesions and demonstrated safety and feasibility, with low morbidity and no mortality. Once the robotic platform was adopted by our surgeons for TAMIS, the procedure was no longer performed laparoscopically. The prone jackknife position has been adequate for lesions in all locations when using the robotic platform. The retrospective design and small sample size were among the study’s limitations, and outcomes were only analyzed at 30 days. Future studies might better elucidate differences and determine surgeons’ preferences regarding both platforms.</p>

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Should we transition to robotic transanal minimally invasive surgery (TAMIS)? A retrospective comparison of short-term outcomes between laparoscopic and robotic TAMIS

  • 期刊论文

  • 发表日期：

    2026年2月23日

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  • Martin Infante Altamirano,
  • Gustavo A. Rubio,
  • Marianna Zeichen,
  • Gustavo Plasencia,
  • Edwin Jimenez,
  • Jazlyn M. Merida,
  • Henry J. Lujan

摘要

Transanal minimally invasive surgery (TAMIS) is a widely used technique for treating rectal neoplasms, traditionally performed using a well-established laparoscopic platform. Recently, robotic TAMIS (R-TAMIS) has gained popularity due to potential advantages in ergonomics, visualization, and instrument dexterity. This study was designed to review the experience of a colorectal surgery group with both robotic and laparoscopic TAMIS (L-TAMIS) and to compare their short-term surgical outcomes. A retrospective chart review was conducted of the last 53 consecutive patients who underwent laparoscopic or robotic TAMIS for rectal neoplasms by four colorectal surgeons from October 2014 to September 2025. We collected data on patient demographics, surgical variables, pathological outcomes,  and 30-day complications. Demographic variables were similar between groups. A significantly larger median lesion size was observed in the R-TAMIS group (3.63 cm vs. 2.49 cm; p = 0.001). The average lesion distance from the anal verge was comparable, 8.08 cm (3–13 cm) for R-TAMIS and 7.52 cm (3–15 cm) for L-TAMIS. The mean operative time was 78 (±26.81) minutes for R-TAMIS and 71 (±25.49) minutes for L-TAMIS. No conversions or 30-day mortalities occurred in either group. After the introduction of R-TAMIS in 2022, operative times remained largely stable over time, with only a slight downward trend and no clear learning-curve effect. There was an approximately USD 757 increase in cost for R-TAMIS compared with L-TAMIS. R-TAMIS was associated with resection of larger lesions and demonstrated safety and feasibility, with low morbidity and no mortality. Once the robotic platform was adopted by our surgeons for TAMIS, the procedure was no longer performed laparoscopically. The prone jackknife position has been adequate for lesions in all locations when using the robotic platform. The retrospective design and small sample size were among the study’s limitations, and outcomes were only analyzed at 30 days. Future studies might better elucidate differences and determine surgeons’ preferences regarding both platforms.