Robotic transanal minimally invasive surgery (R-TAMIS): current evidence in the treatment of early rectal neoplasia
Details
Publication Year 2024-05-09,Volume 39,Issue #1,Page 71
Journal Title
International Journal of Colorectal Disease
Publication Type
Research article
Abstract
INTRODUCTION: Robotic transanal minimally invasive surgery (R-TAMIS) was introduced in 2012 for the excision of benign rectal polyps and low grade rectal cancer. Ergonomic improvements over traditional laparoscopic TAMIS (L-TAMIS) include increased dexterity within a small operative field, with possibility of better surgical precision. We aim to collate the existing data surrounding the use of R-TAMIS to treat rectal neoplasms from cohort studies and larger case series, providing a foundation for future, large-scale, comparative studies. METHODS: Medline, EMBASE and Web of Science were searched as part of our review. Randomised controlled trials (RCTs), cohort studies or large case series (≥ 5 patients) investigating the use of R-TAMIS to resect rectal neoplasia (benign or malignant) were eligible for inclusion in our analysis. Quality assessment of included studies was performed via the Newcastle Ottawa Scale (NOS) risk of bias tool. Outcomes extracted included basic participant characteristics, operative details and histopathological/oncological outcomes. RESULTS: Eighteen studies on 317 participants were included in our analysis. The quality of studies was generally satisfactory. Overall complication rate from R-TAMIS was 9.7%. Clear margins (R0) were reported in 96.2% of patients. Local recurrence (benign or malignant) occurred in 2.2% of patients during the specified follow-up periods. CONCLUSION: Our review highlights the current evidence for R-TAMIS in the local excision of rectal lesions. While R-TAMIS appears to have complication, margin negativity and recurrence rates superior to those of published L-TAMIS series, comparative studies are needed.
Publisher
Springer Nature
Keywords
Female; Humans; Male; Middle Aged; Anal Canal/surgery; Margins of Excision; Minimally Invasive Surgical Procedures/methods; Neoplasm Recurrence, Local/surgery; Postoperative Complications/etiology; *Rectal Neoplasms/surgery/pathology; *Robotic Surgical Procedures/methods/adverse effects; Transanal Endoscopic Surgery/methods; Treatment Outcome; Minimally invasive surgery; Rectal neoplasia; Robotic surgery; Tamis
Department(s)
Surgical Oncology
Open Access at Publisher's Site
https://doi.org/10.1007/s00384-024-04645-4
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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