Transanal excision removes a rectal lesion locally, through the anus, with no abdominal incision, using TAMIS/TEM techniques. It is for selected patients with early tumours or large polyps not removable endoscopically — preserving the rectum.
What is the operation?
It is an organ-preserving local excision of a rectal lesion, done entirely through the anus — with no abdominal incision — using TAMIS/TEM techniques.
It allows removal of suitable, early full-thickness lesions while preserving the rectum and sphincter.
When is it needed?
It is indicated for large rectal polyps not safely removable endoscopically and selected early rectal cancers with favourable features.
Eligibility criteria are strict (e.g. early stage, good differentiation, no lymphovascular invasion, limited size/circumference) and the decision is made at a multidisciplinary team.
Preparation
Precise staging (pelvic MRI, endoscopic ultrasound, endoscopy) is required to confirm suitability and exclude deep invasion or suspicious nodes.
Detailed counselling is given about the possibility of further surgery depending on the final histology.
How it's done
Through a special platform inserted into the anus, the lesion is removed locally, full-thickness and with clear margins, and the wall is sutured. No abdominal incisions or bowel anastomosis are needed.
The specimen is carefully oriented for precise histological margin assessment — decisive for the definitive strategy.
TAMIS
A laparoscopic transanal platform for precise local excision with clear margins.
TEM
A dedicated transanal microsurgery endoscope for suitably located lesions.
Histology-guided
The definitive strategy is individualised based on histology.
Recovery
Recovery is rapid because there is no abdominal incision, with a short stay.
The definitive strategy and follow-up depend on the final histology of the specimen.
Risks & outcomes
In properly selected patients it offers excellent results with preservation of the rectum. Possible complications: bleeding, local healing problems.
The main concern is understaging: if histology shows unfavourable features or positive margins, further, more radical resection may be advised.
Frequently asked questions
Who is it for?
Selected patients with large rectal polyps not removable endoscopically or with early rectal cancers with favourable features, after precise staging.
What is the advantage over rectal resection?
It preserves the rectum and avoids a major operation with a possible stoma, when the lesion is suitable — with faster recovery.
What if the histology is unfavourable?
Further, more radical treatment (e.g. rectal resection) may be advised. That is why selection is careful and multidisciplinary.
Is there an abdominal incision?
No. The operation is done entirely through the anus, with no abdominal incisions or bowel anastomosis.