R-TAMIS

Dr. Gentry Caton performed the first robotic-assisted Trans-Anal Minimally Invasive Surgery (R-TAMIS) in the Wilmington area in January 2020. TAMIS, which is traditionally performed laparoscopically, is a challenging minimally invasive surgical procedure to remove large polyps and early cancers in the lower rectum.

The difficulty in traditional laparoscopic TAMIS procedures is that the defect in the rectal wall is difficult to sew closed. Because the space is small, there is limited range of motion. It is in this aspect that robotics, an R-TAMIS procedure, provides rectal surgeons a distinct advantage.

Manipulating robotic arms give surgeons finer degrees of control within a confined area. It can achieve better angles to suture an area closed after polyps are removed. It also allows larger polyps to be removed completely. The largest lesion Dr. Caton has removed with traditional laparoscopic TAMIS was 3.5cm in size. The robotic approach (R-TAMIS) allowed him to remove a 6cm lesion. Patients who would benefit most from the R-TAMIS are those whose colonoscopy identified large polyps that are not endoscopically resectable or early stage rectal cancers that can be cured with local full thickness resection.