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Minimally Invasive Surgery


Innovative Treatment Options Using Minimally Invasive Techniques

  • Endoscopic and laparoscopic assisted surgery
  • Use of robotics
  • Transanal endoscopic microsurgery (TEM)
  • Transanal minimally invasive surgery (TAMIS)

What is minimally invasive surgery?  This surgery involves making 2-3 smaller incisions approximately 0.5cm in length and one slightly larger incision (4-5cm).  Several types of minimally invasive surgery exist:

  • Laparoscopic assisted surgery -  This surgery involves the use of small ports that are inserted through the abdominal wall.  Fine instruments are passed through a channel in these ports to perform the surgery.   
  • Robotically assisted surgery - This type of surgery is most commonly performed for tumors located in the sigmoid or rectum.  This involves the use of surgeon-guided, robotic arms that help perform precise dissection with enhanced visualization.

What are the benefits of minimally invasive surgery?

  • Smaller incisions
  • Less post-operative pain
  • Decreased use of pain medication
  • Shorter hospital stay

What is TEM and TAMIS? Transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS) are similar techniques that allow surgeons to remove benign polyps and early stage cancers without the use of invasive surgery.

More about TEM  Developed in the 1980s, TEM was created  to enable surgeons to remove polyps and tumors in the  rectum using a port placed through the rectum and a microscopic lens.  This technology has demonstrated precise excision of polyps and tumors with preservation of anal sphincter muscle control. 

More about TAMIS  TAMIS was developed in 2009 and has been utilized for the same indications as TEM. 

What is the difference between TEM and TAMIS?  The primary difference between the two techniques is that a resterilized, reusable port is used for TEM, while a disposable port is used for TAMIS.

What are the benefits of TEM and TAMIS?  Many benefits have been noted for patients undergoing TEM and TAMIS: no visible incisions, decreased postoperative pain, faster recovery, and a shorter hospital stay. Some patients will even be discharged home the day of surgery.

Not all patients are candidates for minimally invasive surgery due to prior surgical history, overall fitness for surgery, and stage of cancer.  Discuss with your surgeon if you are a candidate for minimally invasive surgery and which approach is appropriate for you.