Trans Anal Minimally Invasive Surgery
Trans Anal Minimally Invasive Surgery (TAMIS) is a highly specialised form of rectal surgery which involves operating in and around the rectum. Access to the rectum is gained by placing a special device in the anus which allows the rectum to be inflated with carbon dioxide gas. TAMIS and its predecessor TEM (Trans anal Endoscopic Microsurgery) have revolutionised rectal surgery.
The history of rectal surgery
In the late 19th century operations for rectal cancer were inadequate and the outcomes were poor. Subsequently Ernest Miles, an english surgeon, pioneered an operation to remove all of the rectum and the anus if a cancer was present. This operation had a high mortality and so some surgeons moved to try to remove the cancer through the anus. Sir Alan Parks developed a retarctor to aid in this surgery which remained crude and unsatisfactory until the development of TEMS in the mid 80's.
In 1983 Dr Gerhard Buess perfected an operating microscope which allowed controlled and accurate surgery to be performend within the rectum. This revolutionised rectal surgery. Mr Miles trained with Dr Buess in 2000 and brought this technique to Worthing. The TEM equipment however is complex and on occasion difficult to use.
In 2012 Mr Miles travelled to Orlando Florida to study with Dr Matt Albert and Dr Sam Atallah who have pioneered a new rectal access system called Gelpoint Path. This has improved flexibility over the TEMS equipment and has significantly broadened the scope of this type of rectal surgery.
Mr Miles is now an international expert on TAMIS surgery and has run training courses for this technique both in England and Europe. He was an invited expert speaker at the Association of Surgeons of Great Britian and Ireland meeting in 2013 and has been invited to speak at the International Rectal Polyp meeting in Genoa in 2014.
TAMIS surgery is suitable for patients with benign rectal polyps and also for patients with early rectal cancer. The TAMIS technique may also be used for patients with very low rectal cancers who wish to avoid a colostomy.
For more information about TAMIS surgery please contact The East Preston Clinic.