title: Transanal Minimally Invasive Surgery (TAMIS): Standardizing a Reproducible Procedure.
abstract: BACKGROUND
  The recent introduction of transanal minimally invasive surgery (TAMIS) offers a safe and cost-effective method for the local resection of rectal neoplasms. The ability to standardize a technique for TAMIS will lead to the most reproducible outcomes and enable teaching.
  
  
  METHODS
  A retrospective, IRB-approved chart review was conducted of 32 patients who underwent the TAMIS procedure at one institution over a 3-year period.
  
  
  RESULTS
  TAMIS was performed for 11 benign and 21 malignant lesions. The majority of resections were full thickness (29/32) and all were R0. Average distance from the anal verge was 7.5 ± 3 cm, defect circumference was 43.7 ± 10%, operative time was 131 ± 80 min, and length of stay was 1.1 ± 1 days. Two patients had morbidities requiring readmission and further treatment for (1) an aspiration pneumonia with CHF exacerbation and (2) a rectal abscess.
  
  
  CONCLUSIONS
  This report outlines an operative technique for TAMIS that is reproducible for the excision of rectal lesions, associated with low morbidity.
authors.affiliation: Division of General and Gastrointestinal Surgery, Emory University, Atlanta, GA, USA, sujatagill427@gmail.com.
authors.forename: Sujata
authors.initials: S
authors.lastname: Gill
authors.forename: Jamil L
authors.initials: JL
authors.lastname: Stetler
authors.forename: Ankit
authors.initials: A
authors.lastname: Patel
authors.forename: Virginia O
authors.initials: VO
authors.lastname: Shaffer
authors.forename: Jahnavi
authors.initials: J
authors.lastname: Srinivasan
authors.forename: Charles
authors.initials: C
authors.lastname: Staley
authors.forename: S Scott
authors.initials: SS
authors.lastname: Davis
authors.forename: Edward
authors.initials: E
authors.lastname: Lin
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Sullivan
mesh_terms: D000038:Abscess; D000230:Adenocarcinoma / Q000601:surgery*; D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011015:Pneumonia, Aspiration; D011183:Postoperative Complications; D012002:Rectal Diseases / Q000601:surgery; D012004:Rectal Neoplasms / Q000601:surgery*; D012015:Reference Standards; D012189:Retrospective Studies; D000067368:Transanal Endoscopic Surgery / Q000379:methods*; D014456:Ulcer / Q000601:surgery*