1. Transanal Rectal Excision: Video Demonstration Of A TAMIS Technique
Albert M. Wolthuis, MD. Anthony de Buck van Overstraeten, MD. André D’Hoore, MD, PhD.
Department of Abdominal Surgery

2. Problems with laparoscopic distal rectal mobilisation
Visualisation
Bony landmarks
Adaptation of instruments

3. TAMIS: TransAnal Minimally Invasive Surgery
Intraluminal
Extraluminal
~TEM/TEO ~TATA, TSPM, MA-NOS, …
Rectal adenoma ‘Bottom-up TME’
Early rectal cancer ‘Reverse TME’

4. TAMIS: TransAnal Minimally Invasive Surgery
Intraluminal
Extraluminal
~TEM/TEO ~TATA, TSPM, MA-NOS, …
Rectal adenoma ‘Bottom-up TME’
Early rectal cancer ‘Reverse TME’

5. 1 2 3 uterus 4 endopelvic fascia
Wolthuis et al,Tech Coloproctol. 2012;16:

6. Manual coloanal anastomosis

7. Transanal rectal excision
Promising technique
distal rectal mobilisation under direct vision
Future:
Improvement of instruments
Robotics?
NOTES TME