title: A New Reusable Platform for TransAnal Minimally Invasive Surgery: First Experience.
abstract: BACKGROUND
  TransAnal Minimally Invasive Surgery (TAMIS) has generated interest and attracted research in the last decade. This approach is used to treat primary benign and malignant diseases, but it can also be adopted to resolve colorectal complications, such as leak and fistula, bleeding and stenosis. A new reusable transanal platform formed by a new port and monocurved instruments has been invented and here presented.
  
  
  METHODS
  The first experience included 13 patients submitted to TAMIS for rectal adenocarcinoma (8), immediate colorectal leak (1), early rectovaginal fistula (1), late colorectal fistula (1), immediate colorectal bleeding (1), and benign stenosis (1). Mean age was 62.3 years (38-74), and mean BMI was 25.2 kg/m2 (20.5-32.1).
  
  
  RESULTS
  Mean operative time for transanal total mesorectal excision (TME) was 149.2 minutes (96-193) and for the other procedures 80.6 minutes (15-163). Mean operative bleeding was 51.1 cc (0-450). Mean hospital stay was 5.0 days (2-8). The 3 patients with coloanal anastomosis presented diarrhea postoperatively. No other early postoperative complications were registered. Pathologic report in the oncologic diseases showed that a mean number of 14.7 nodes (16-20) were removed. After a mean follow-up of 8 months (1-14), there were no late complications in any of the 13 patients treated.
  
  
  CONCLUSIONS
  TAMIS is a feasible alternative approach to treat rectal cancer and a completely new technique to manage colorectal complications. Moreover, this new transanal platform offers surgeons a satisfactory working ergonomy, with no increase in cost of the procedures, because entirely reusable materials are adopted.
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Dapri
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: Guta
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Luca
authors.initials: L
authors.lastname: Cardinali
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Claudia
authors.initials: C
authors.lastname: Mazzetti
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Anny Cadenas
authors.initials: AC
authors.lastname: Febres
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Grozdev
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Sixte-Henry
authors.initials: SH
authors.lastname: Sondji
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Ion
authors.initials: I
authors.lastname: Surdeanu
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Guy-Bernard
authors.initials: GB
authors.lastname: Cadière
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D017743:Equipment Reuse; D006801:Humans; D020706:Laparoscopes; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D057605:Natural Orifice Endoscopic Surgery / Q000295:instrumentation*; D010865:Pilot Projects; D012002:Rectal Diseases / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome