Historical Perspectives and Rationale for Development

  • Sergio W. Larach
  • Beatriz Martín-Pérez


 This chapter explores the evolution of transanal surgery. It highlights the rationale for excision over radical resection, and accounts the advancements in technology which led to the development of TAMIS. The change of focus from higher reach to access proximal lesions, to better quality surgery and local excision in all segments of the rectum with TEM, was fundamental in the evolution of all transanal surgery, including TAMIS.


Transanal minimally invasive surgery (TAMIS), History of TAMIS Parks transanal excision (TAE), Transanal endoscopic microsurgery (TEM) Transanal endoscopic operation (TEO) Single-port incision 


  1. 1.
    Nathan BN. Excision of rectal cancer: the first reported case. Can J Surg. 1991;34(2):108.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Wilson SE, Gordon HE. Excision of rectal lesions by the Kraske approach. Am J Surg. 1969;118(2):213–7.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Miles WE. A method of performing abdomino-perineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon (1908). CA Cancer J Clin. 1971;21(6):361–4.CrossRefGoogle Scholar
  4. 4.
    Rosen L, Veidenheimer MC, Coller JA, Corman ML. Mortality, morbidity, and patterns of recurrence after abdominoperineal resection for cancer of the rectum. Dis Colon Rectum. 1982;25(3):202–8.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Gastrointestinal Tumor Study G. Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med. 1985;312(23):1465–72.CrossRefGoogle Scholar
  6. 6.
    Luna-Perez P, Rodriguez-Ramirez S, Vega J, Sandoval E, Labastida S. Morbidity and mortality following abdominoperineal resection for low rectal adenocarcinoma. Rev Investig Clin. 2001;53(5):388–95.Google Scholar
  7. 7.
    Wang YW, Huang LY, Song CL, Zhuo CH, Shi DB, Cai GX, et al. Laparoscopic vs open abdominoperineal resection in the multimodality management of low rectal cancers. World J Gastroenterol. 2015;21(35):10174–83.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995;333(22):1456–61.CrossRefGoogle Scholar
  9. 9.
    Morson BC, Bussey HJ, Samoorian S. Policy of local excision for early cancer of the colorectum. Gut. 1977;18(12):1045–50.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Steele GD Jr, Herndon JE, Bleday R, Russell A, Benson A 3rd, Hussain M, et al. Sphincter-sparing treatment for distal rectal adenocarcinoma. Ann Surg Oncol. 1999;6(5):433–41.CrossRefGoogle Scholar
  11. 11.
    You YN, Baxter NN, Stewart A, Nelson H. Is the increasing rate of local excision for stage I rectal cancer in the United States justified?: a nationwide cohort study from the National Cancer Database. Ann Surg. 2007;245(5):726–33.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Madbouly KM, Remzi FH, Erkek BA, Senagore AJ, Baeslach CM, Khandwala F, et al. Recurrence after transanal excision of T1 rectal cancer: should we be concerned? Dis Colon Rectum. 2005;48(4):711–9. discussion 9-21.CrossRefGoogle Scholar
  13. 13.
    Garcia-Aguilar J, Mellgren A, Sirivongs P, Buie D, Madoff RD, Rothenberger DA. Local excision of rectal cancer without adjuvant therapy: a word of caution. Ann Surg. 2000;231(3):345–51.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Greenberg JA, Shibata D, Herndon JE 2nd, Steele GD Jr, Mayer R, Bleday R. Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984. Dis Colon Rectum. 2008;51(8):1185–91. discussion 91-4.CrossRefGoogle Scholar
  15. 15.
    McCall JL, Cox MR, Wattchow DA. Analysis of local recurrence rates after surgery alone for rectal cancer. Int J Color Dis. 1995;10(3):126–32.CrossRefGoogle Scholar
  16. 16.
    Mellgren A, Sirivongs P, Rothenberger DA, Madoff RD, Garcia-Aguilar J. Is local excision adequate therapy for early rectal cancer? Dis Colon Rectum. 2000;43(8):1064–71. discussion 71-4.CrossRefGoogle Scholar
  17. 17.
    Gillern SM, Mahmoud NN, Paulson EC. Local excision for early stage rectal cancer in patients over age 65 years: 2000-2009. Dis Colon Rectum. 2015;58(2):172–8.CrossRefGoogle Scholar
  18. 18.
    Lau WY, Leow CK, Li AK. History of endoscopic and laparoscopic surgery. World J Surg. 1997;21(4):444–53.CrossRefGoogle Scholar
  19. 19.
    Hatzinger M, Fesenko A, Sohn M. The first human laparoscopy and NOTES operation: Dimitrij Oscarovic Ott (1855-1929). Urol Int. 2014;92(4):387–91.CrossRefGoogle Scholar
  20. 20.
    Rock JA, Warshaw JR. The history and future of operative laparoscopy. Am J Obstet Gynecol. 1994;170(1 Pt 1):7–11.CrossRefPubMedGoogle Scholar
  21. 21.
    Buess G, Theiss R, Gunther M, Hutterer F, Pichlmaier H. Transanal endoscopic microsurgery. Leber Magen Darm. 1985;15(6):271–9.PubMedGoogle Scholar
  22. 22.
    Winde G, Nottberg H, Keller R, Schmid KW, Bunte H. Surgical cure for early rectal carcinomas (T1). Transanal endoscopic microsurgery vs. anterior resection. Dis Colon Rectum. 1996;39(9):969–76.CrossRefPubMedGoogle Scholar
  23. 23.
    de Graaf EJ, Burger JW, van Ijsseldijk AL, Tetteroo GW, Dawson I, Hop WC. Transanal endoscopic microsurgery is superior to transanal excision of rectal adenomas. Color Dis. 2011;13(7):762–7.CrossRefGoogle Scholar
  24. 24.
    Middleton PF, Sutherland LM, Maddern GJ. Transanal endoscopic microsurgery: a systematic review. Dis Colon Rectum. 2005;48(2):270–84.CrossRefPubMedGoogle Scholar
  25. 25.
    Buess GF, Misra MC, Bhattacharjee HK, Becerra Garcia FC, Bansal VK, Bermudez JR. Single-port surgery and NOTES: from transanal endoscopic microsurgery and transvaginal laparoscopic cholecystectomy to transanal rectosigmoid resection. Surg Laparosc Endosc Percutan Tech. 2011;21(3):e110–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Moore JS, Cataldo PA, Osler T, Hyman NH. Transanal endoscopic microsurgery is more effective than traditional transanal excision for resection of rectal masses. Dis Colon Rectum. 2008;51(7):1026–30. discussion 30-1.CrossRefPubMedGoogle Scholar
  27. 27.
    O’Neill CH, Platz J, Moore JS, Callas PW, Cataldo PA. Transanal endoscopic microsurgery for early rectal Cancer: a single-center experience. Dis Colon Rectum. 2017;60(2):152–60.CrossRefPubMedGoogle Scholar
  28. 28.
    Clancy C, Burke JP, Albert MR, O’Connell PR, Winter DC. Transanal endoscopic microsurgery versus standard transanal excision for the removal of rectal neoplasms: a systematic review and meta-analysis. Dis Colon Rectum. 2015;58(2):254–61.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Suppiah A, Maslekar S, Alabi A, Hartley JE, Monson JR. Transanal endoscopic microsurgery in early rectal cancer: time for a trial? Color Dis. 2008;10(4):314–27. discussion 27-9.CrossRefGoogle Scholar
  30. 30.
    Jones HJS, Hompes R, Mortensen N, Cunningham C. Modern management of T1 rectal cancer by TEM:a ten-year single-centre experience. Color Dis. 2018;20:586.CrossRefGoogle Scholar
  31. 31.
    Heintz A, Morschel M, Junginger T. Comparison of results after transanal endoscopic microsurgery and radical resection for T1 carcinoma of the rectum. Surg Endosc. 1998;12(9):1145–8.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Kidane B, Chadi SA, Kanters S, Colquhoun PH, Ott MC. Local resection compared with radical resection in the treatment of T1N0M0 rectal adenocarcinoma: a systematic review and meta-analysis. Dis Colon Rectum. 2015;58(1):122–40.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Maya A, Vorenberg A, Oviedo M, da Silva G, Wexner SD, Sands D. Learning curve for transanal endoscopic microsurgery: a single-center experience. Surg Endosc. 2014;28(5):1407–12.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Koebrugge B, Bosscha K, Ernst MF. Transanal endoscopic microsurgery for local excision of rectal lesions: is there a learning curve? Dig Surg. 2009;26(5):372–7.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Atallah S, Keller D. Why the conventional parks transanal excision for early stage rectal cancer should be abandoned. Dis Colon Rectum. 2015;58(12):1211–4.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Martin-Perez B, Andrade-Ribeiro GD, Hunter L, Atallah S. A systematic review of transanal minimally invasive surgery (TAMIS) from 2010 to 2013. Tech Coloproctol. 2014;18(9):775–88.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Nieuwenhuis DH, Draaisma WA, Verberne GH, van Overbeeke AJ, Consten EC. Transanal endoscopic operation for rectal lesions using two-dimensional visualization and standard endoscopic instruments: a prospective cohort study and comparison with the literature. Surg Endosc. 2009;23(1):80–6.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Pelosi MA, Pelosi MA 3rd. Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med. 1992;37(7):588–94.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Patel CB, Ramos-Valadez DI, Ragupathi M, Haas EM. Single incision laparoscopic-assisted right hemicolectomy: technique and application (with video). Surg Laparosc Endosc Percutan Tech. 2010;20(5):e146–9.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Cianchi F, Staderini F, Badii B. Single-incision laparoscopic colorectal surgery for cancer: state of art. World J Gastroenterol. 2014;20(20):6073–80.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Atallah S, Albert M, Larach S. Transanal minimally invasive surgery: a giant leap forward. Surg Endosc. 2010;24(9):2200–5.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Atallah SB, Albert MR. Transanal minimally invasive surgery (TAMIS) versus transanal endoscopic microsurgery (TEM): is one better than the other? Surg Endosc. 2013;27(12):4750–1.CrossRefGoogle Scholar
  43. 43.
    Gomez Ruiz M, Cagigas Fernandez C, Alonso Martin J, Cristobal Poch L, Manuel Palazuelos C, Barredo Canibano FJ, et al. Robotic assisted transanal polypectomies: is there any indication? Cir Esp. 2017;95(10):601–9.CrossRefGoogle Scholar
  44. 44.
    Hompes R, Rauh SM, Ris F, Tuynman JB, Mortensen NJ. Robotic transanal minimally invasive surgery for local excision of rectal neoplasms. Br J Surg. 2014;101(5):578–81.CrossRefGoogle Scholar
  45. 45.
    Atallah S, Drake J, Martin-Perez B, Kang C, Larach S. Robotic transanal total mesorectal excision with intersphincteric dissection for extreme distal rectal cancer: a video demonstration. Tech Coloproctol. 2015;19(7):435.CrossRefGoogle Scholar
  46. 46.
    Albert MR, Atallah SB, deBeche-Adams TC, Izfar S, Larach SW. Transanal minimally invasive surgery (TAMIS) for local excision of benign neoplasms and early-stage rectal cancer: efficacy and outcomes in the first 50 patients. Dis Colon Rectum. 2013;56(3):301–7.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Lee L, Burke JP, deBeche-Adams T, Nassif G, Martin-Perez B, Monson JRT, et al. Transanal minimally invasive surgery for local excision of benign and malignant rectal neoplasia: outcomes from 200 consecutive cases with midterm follow up. Ann Surg. 2018;267(5):910–6.CrossRefGoogle Scholar
  48. 48.
    Lorenz C, Nimmesgern T, Back M, Langwieler TE. Transanal single port microsurgery (TSPM) as a modified technique of transanal endoscopic microsurgery (TEM). Surg Innov. 2010;17(2):160–3.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Matz J, Matz A. Use of a SILS port in transanal endoscopic microsurgery in the setting of a community hospital. J Laparoendosc Adv Surg Tech A. 2012;22(1):93–6.CrossRefGoogle Scholar
  50. 50.
    van den Boezem PB, Kruyt PM, Stommel MW, Tobon Morales R, Cuesta MA, Sietses C. Transanal single-port surgery for the resection of large polyps. Dig Surg. 2011;28(5–6):412–6.CrossRefGoogle Scholar
  51. 51.
    Barendse RM, Doornebosch PG, Bemelman WA, Fockens P, Dekker E, de Graaf EJ. Transanal employment of single access ports is feasible for rectal surgery. Ann Surg. 2012;256(6):1030–3.CrossRefGoogle Scholar
  52. 52.
    Ragupathi M, Haas EM. Transanal endoscopic video-assisted excision: application of single-port access. JSLS. 2011;15(1):53–8.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Lim SB, Seo SI, Lee JL, Kwak JY, Jang TY, Kim CW, et al. Feasibility of transanal minimally invasive surgery for mid-rectal lesions. Surg Endosc. 2012;26(11):3127–32.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Hompes R, Ris F, Cunningham C, Mortensen NJ, Cahill RA. Transanal glove port is a safe and cost-effective alternative for transanal endoscopic microsurgery. Br J Surg. 2012;99(10):1429–35.CrossRefGoogle Scholar
  55. 55.
    Watts ES, Peacock O, Gupta A, Speake WJ, Lund JN. Anyone for TAMIS? Tech Coloproctol. 2013;17(2):253–5.CrossRefGoogle Scholar
  56. 56.
    Slack T, Wong S, Muhlmann M. Transanal minimally invasive surgery: an initial experience. ANZ J Surg. 2014;84(3):177–80.CrossRefGoogle Scholar
  57. 57.
    Smith RA, Anaya DA, Albo D, Artinyan A. A stepwise approach to transanal endoscopic microsurgery for rectal cancer using a single-incision laparoscopic port. Ann Surg Oncol. 2012;19(9):2859.CrossRefGoogle Scholar
  58. 58.
    McLemore EC, Coker A, Jacobsen G, Talamini MA, Horgan S. eTAMIS: endoscopic visualization for transanal minimally invasive surgery. Surg Endosc. 2013;27(5):1842–5.CrossRefGoogle Scholar
  59. 59.
    Lee TG, Lee SJ. Transanal single-port microsurgery for rectal tumors: minimal invasive surgery under spinal anesthesia. Surg Endosc. 2014;28(1):271–80.CrossRefGoogle Scholar
  60. 60.
    Caycedo-Marulanda A, Jiang HY, Kohtakangas EL. Transanal minimally invasive surgery for benign large rectal polyps and early malignant rectal cancers: experience and outcomes from the first Canadian centre to adopt the technique. Can J Surg. 2017;60(6):416–23.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sergio W. Larach
    • 1
  • Beatriz Martín-Pérez
    • 2
  1. 1.Endosurgical Center of FloridaOrlandoUSA
  2. 2.Hospital Clinic, Barcelona (Spain), Gastrointestinal SurgeryBarcelonaSpain

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