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 a special laparoscopic platform (TAMIS) or a dedicated endoscope (TEM). It avoids a major rectal resection in suitable, early lesions.
When is it needed?
It is indicated for large rectal polyps not safely removable endoscopically and selected early rectal cancers with favourable features. Suitability is judged after precise staging.
Preparation
It requires precise staging (pelvic MRI, endoscopic ultrasound, endoscopy) to confirm suitability. The decision is made at a multidisciplinary team.
How it's done
Through a special platform inserted into the anus, the lesion is removed locally with clear margins and the wall is sutured. No abdominal incisions or bowel anastomosis are needed.
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 depends on the histology of the specimen.
Risks & outcomes
In properly selected patients it offers excellent results with preservation of the rectum. If histology shows unfavourable features, further, more radical treatment may be advised. Possible complications: bleeding, local healing problems.
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.