We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.

You must be logged in to watch this video. Click here to access your account, or here to register for free!

  • 2194
  • 2017-09-11

Transanal minimally invasive surgical anal canal polyp resection

Epublication WebSurg.com, Sep 2017;17(09). URL:
You must be logged in to ask a question to authors. Click here to access your account, or here to register for free!
Background: Endoscopic submucosal dissection (ESD) has been known for a long time. Recently, transanal minimally invasive surgery (TAMIS) started to be popularized and it can be used in front of difficult cases for ESD.
Video: A 36-year-old woman underwent a TAMIS resection, after unsuccessful ESD, for a 2cm polyp located anteriorly in the anal canal, just beside the pectineal line. Preoperative work-up showed a uT1m versus T1sm N0 M0 lesion. The patient was placed in a prone position with a split leg kneeling position. The procedure was performed with a new reusable transanal platform, a monocurved coagulating hook, and a grasping forceps. The mucosal flap was closed using two absorbable running sutures, a monocurved needle holder, and a grasping forceps.
Results: Operative time was 90 minutes, and perioperative bleeding was 20cc. No perioperative complications were noted, and the patient was discharged on postoperative day 1. Pathological findings showed a 2 by 1.3 by 0.5cm villotubular adenoma with high-grade dysplasia and free margins.
Conclusions: TAMIS anal canal polyp resection allows for a meticulous dissection under a magnified exposure of the operative field, with a final mucosal flap closure in adequate ergonomic conditions.